Kankakee Community College
Veteran Educational Benefits Request Form
Date of birth: ____/____/____ KCC I.D. no.: Social Security no. - -
Street address:
City: State: ZIP code:
( )
Veteran status: Veteran Active Duty Spouse Dependent
Dependent/Spouse only:
Veteran’s Social Security no.: - -
Have any other dependents of this veteran used his/her benefits before you? No Yes If yes, how many?
Ill. Veteran Grant MIA/POW CH 31/19 (Voc. Rehab)
Post 9/11-CH 33 CH 1606 (Guard & Reserve)
CH 1607/REAP
Ill. National Guard Grant
CH 30 (GI Bill
CH 35 (Dependents)
CERTIFICATION PERIOD Please answer only if using Federal VA Benefits (CH 30, CH 33, CH 1606, CH 1607, CH 35):
Current degree/major (from the KCC catalog):
TERM **If this is a change of major from your last semester using your GI Bill or you are a new student,
you will need to complete a VA Change of Training/Program form.
I hereby certify that all statements are true and complete to the best of my knowledge and belief:
I authorize release of school and testing records to the VA and Illinois Student Assistance Commission for use in advising me and
supervising my program of education and training.
If I stop attending classes and/or earn a failing grade, the school is required to
report the last date of attendance to the VA and I may owe the VA if the grade was not earned.
I will only be certied for classes that are required for the above stated degree.
I cannot receive payment for audited classes or repeated classes with a grade of D or better, unless it is for graduation requirements.
Registering prior to completion of the ofcial evaluation of high school, college, and/or military transcripts may have nancial
implications, including requirement to return VA funds for which I have previously received credit.
I am held to the same Academic Standing requirements as all students at KCC.
I am responsible for notifying the Ofce of Financial Aid within two weeks of ANY changes in my program/curriculum and semester
hours enrolled.
Non-compliance with school and VA regulations may result in an overpayment which I understand that I must repay.
I must request certication of benets each semester.
Post 9/11 – Chapter 33 benet recipients: The housing allowance is paid if the student’s rate of pursuit is more than 50%. Individuals
only enrolled in distance learning courses will be eligible for a monthly housing allowance equal to 50%. The applicable Basic Allowance
for Housing rate will be multiplied by the rate of pursuit, rounded to the nearest multiple of 10.
Signature of student Date signed
Post 9/11-Chapter 33- tuition and fees (including lab) Vocational Rehabilitation – tuition, service,
Approved percentage of benets lab fees, books
IVG - tuition and service fees MIA/POW tuition and service fees
ING - tuition and service fees
Rev. 11/2018
To be completed by the KCC Office of Financial Aid
Gap Access Info. Date:
Points used to date:
Award year:
First, print form. Then manually sign and send to: Kankakee Community College, Kendra Souligne, Coordinator of Financial Aid and Veteran
Services, 100 College Drive, Kankakee, IL 60901. Question? Contact Kendra Souligne, 815-802-8550 or email finaid@kcc.edu.