Expanded Information for VA Benefits
Information Sheet (VBIS)
Complete this form to ensure your VA information is up-to-date. Please do not submit this form without a recent certificate of eligibility (COE), eBenefits
statement or W.A.V.E. capture, as we will be unable to update your record without at least one of these documents.
Date University ID First Name Last Name Branch of Service Military Status
Select your current VA education benefits program
I am submitting my COE with my VBIS.
Chapter 31 Vocational Rehabilitation for Disabled Veterans
I understand I must submit a VA 28-1905 form.
I understand that I should only register for courses via telephone or fax.
I understand that TESU does not provide book vouchers.
Chapter 33 Post-9/11 GI Bill
I understand that a certification cannot be submitted unless I take at least one course at TESU.
I understand I am responsible for payment of all balances in the event the VA does not make payment.
I acknowledge that due to this reason, TESU highly recommends I apply for financial aid or Yellow Ribbon.
Please select your length of service as indicated within your VA COE. % of Maximum Benefit Payable
Chapter 35 Survivors & Dependents Educational Assistance
VA file number:
Please note: this number is not your SSN.
Please contact the VA directly at 888-442-4551 if you
do not know your file number.
Check the appropriate options:
NoYes I am an actively drilling reservist.
NoYes I am using active-duty military tuition assistance (TA).
Yes No I am using Top-Up to supplement my TA.
NoYes I have submitted a 22-1995 after attending another institution.
NoYes I have applied for financial aid.
NoYes I am a New Jersey Army or Air National Guardsman and have submitted my NJNGTP Registration Package.
If the above options are not working, please complete the requested information and submit this form to firstname.lastname@example.org, or fax to the number above.
Office of Military & Veteran