Veteran Resource Center
Student Intake Form
Student ID:
Personal Information
Military Information
Branch of Service:
Army
Air Force
Coast Guard
Navy
Marine Corps
Guard/Reserve
Post 9/11 Veteran: Dependent:
Yes
No
Yes
No
Education Information
What is your degree, major, and/or certificate at Delta College?
If you are using benefits, select which one(s) you will be using?
Post 9/11 (Ch. 33)
Montgomery GI Bill
(Ch. 30)
31
Select Reserve
(1606)
REAP (1607)
Dependents (Ch. 35)
Waiver
Tuition
Assistance
List any prior colleges you have attended
1.
2.
3.
4.
Last Name:
First Name:
Personal Email:
School Email:
Phone #
Mailing Address: