Military Benefit Request Form, PSC School Code: 001640
Read and complete this form. Do not leave any blanks.


Select all that apply

Federal Montgomery GI Bill
State Grants
Other Veteran Tuition Assistance:
Have you changed majors? *
Are you repeating a course(s)? *

Read each statement and initial below

I understand the term financial aid includes state and federal funds including but not limited to: Monetary Award
Program (MAP), Pell, Supplemental Educational Opportunity Grant (SEOG), IIA, student loans, military benefits, and
scholarships.

If my financial aid does not completely cover my tuition bill or I am ineligible for financial aid, I am responsible for
making payment immediately to the Business Office.

I realize that until all requested information has been submitted, reviewed, and verified, financial aid will not
be credited to my student account, and I will not be allowed a book voucher if eligible.

I have reviewed the Standards of Progress, and I understand I must meet all of the guidelines to continue receiving
Veteran educational benefits. This includes maintaining a 2.0 cumulative grade point average (GPA) of the total
attempted course hours.

I understand that each semester I must submit a Military Benefit Request form with a copy of my final class schedule. I must immediately submit a copy of my class schedule to the Coordinator of Veteran Affairs when any changes are made.

I understand that PSC will begin processing new enrollment certifications 45 days-prior to the start of each term and may take up to three weeks to be processed. Only one class schedule can be submitted for certification. Any additional adjustments increasing enrollment will not be processed until after the first refund period. Any adjustments decreasing enrollment may reduce my monthly educational benefits. Failure to submit a final schedule or report schedule changes can impact my certification and receipt of educational benefits.

Department of Veteran Affairs (DVA) will not pay for courses I do not attend, courses I withdraw from, and courses I complete but receive a grade that will not count towards graduation. Courses not successfully completed (including grades of "F") may result in returned tuition and fees to DVA and/or reduction of monthly benefits.

A punitive grade is a grade assigned for pursuit of a course which is used in determining the students overall progress toward completion of the schools requirements for graduation.

If for some reason I stop attending my courses, my school will reduce my enrollment based on the last date I attended or last submission of work and not my official withdrawal date.

For 911 GI Bill Benefits, I understand I must submit all previous transcripts to Enrollment Services for review.Failure to do so in a timely manner can result in postponed educational payments by the Department of Veteran
Affairs.

I understand I can not owe a repayment on any federal or state student financial aid program or be in default on a student loan and receive financial aid.

I understand that not all classes or programs are eligible for financial aid and Military Benefits, including student loans. Even if eligible for financial aid, these courses/programs will not be paid or certifies with these funds.

I understand I am responsible for dropping my classes if I choose not to attend PSC.

I understand that PSC’s financial aid office may request additional documentation to complete my financial aid award.

Federal education benefits are earned not pre-awarded. Therefore monthly benefits are paid during the beginning of the month for the previous month.

Missing in Action Grant do not cover books or lab fees. Students are encouraged to complete the Finaicial Aid Process to see if they are eligible for additional federal assistance or a scholarship.

Enrollment certifications will not be processed until all required documents are submitted and your classes match your selected major on file with the Department of Veteran Affairs.

I understand I must complete a Change of Place/Training Form (VA Form 22-5495) for Fry Scholarship, Chapter 33 TOE and 35 and a PSC Transcript Evaluation Form if I decide to change my major. Both Forms can be found under Forms and Brochures in the Financial Aid section at www.prairiestate.edu.

I understand that if I leave a school/program due to unsatisfactory attendance, progress, or conduct I must reenter the same program.


I certify that I have read and understand all items within this form and all information provided for my financial aid is true and correct.

Date: Tuesday, 19 September 2017 (EDT)
Name:
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