VA Form 22-1990 Application for VA Education Benefits

What Is VA Form 22-1990?

VA Form 22-1990, Application for VA Education Benefits is a document used for applying for the veterans' educational benefits and assistance.

The latest version of the form was released by the Department of Veterans Affairs (VA) in December 2016 and replaces the now obsolete November 2014 edition. An up-to-date VA Form 22-1990 fillable version is available for download below or can be found through on the Department of Veterans Affairs website.

The 22-1990 - also known as the GI Bill form - is applicable to several country-wide programs including the following:

  • Post-9/11 GI Bill (for military veterans having served since September 11, 2001);
  • Montgomery GI Bill - or MGIB (for active duty members who enroll and pay $100 per month for 12 months and are then entitled to receive a monthly education benefit once after completing a minimum service obligation);
  • Montgomery GI Bill for Selected Reserve - or MGIB-SR (for reservists having a six-year obligation in the Selected Reserve and actively drilling);
  • Post-Vietnam Era Veterans' Educational Assistance Program - or VEAP.

VEAP is applicable to duty members that have joined the Army between January 1, 1977, and June 30, 1985, opened a contribution account before April 1, 1987, contributed from $25 to $2,700, completed their first period of service and were discharged or released from service under any conditions other than dishonorable. Servicemembers on active duty have the right to receive VEAP benefits if they have three or more months of contributions available.

The 22-1990 can be used for a college degree and certificate programs, technical and vocational courses, licensing and certification tests, apprenticeships or on-the-job training, hi-tech training, flight training, entrepreneurship training, certain entrance examinations, and correspondence courses. It cannot be used for vocational rehabilitation and employment benefits, Marine Gunnery Sergeant John David Fry scholarship, transfer of entitlement, or national call to service. A person can apply for these benefits using other documents.

VONAPP 22-1990 Form Applications

Earlier, the VA Form 22-1990 could be filled through the Veteran On-Line Application service (VONAPP). This program has been retired since September 2017 and the VONAPP website is no longer available to users.

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VA Form 22-1990 Instructions

The 22-1990 Form can be filed and submitted online through the Veterans Benefits Administration Education and Training website.

If a candidate needs planning individual educational and career goals, the VA can offer a variety of counseling services to help them with their decision. These services include educational and vocational guidance together with the necessary testing to determine the candidate's skills, talents, and interests.

For more information on VA counseling call 1-888-GI-BILL-1 or 1-888-442-4551.

How to Fill Out VA Form 22-1990?

The candidate should provide their personal data, select the benefits being applied for, as well as the type and program of education or training. Other information includes service, education and employment details, marital and dependency status along with the entitlement to and usage of any additional types of assistance.

Individuals who have already selected a school or training establishment should take the following steps:

Step 1. Mail the completed application to the VA Regional Processing Office for the region of that school's physical address.

Step 2. Approve the request for VA education benefits with the veteran officials at the chosen school or training establishment. These will officials will have to provide your enrollment information to the VA using the VA Form 22-1999, Enrollment Certification, or its electronic version.

Step 3. Wait for the department to process the document and to send the notification of its decision concerning the candidate's rights for education benefits.

Individuals who have not yet selected a school or training establishment should take the following steps:

Step 1: Mail the completed application to the VA Regional Processing Office for the region of their home address.

Step 2: Wait for VA to process the document and deliver a notification of its decision concerning the candidate's rights for education benefits.

VA 22-1990 Related Forms

  1. VA Form 22-1990E, Application for Family Member to Use Transferred Benefits is a form used to apply for a Transfer of Entitlement (TOE) to dependent family members and is filed by servicemembers eligible to transfer benefits to their dependents. The servicemember's military branch should approve the request to transfer benefits. The VA Form 22-1990e cannot be used for claiming the servicemember's own benefits.
  2. VA Form 22-1990T, Application for Individualized Tutorial Assistance is used to apply for supplemental payments for tutorial assistance. The subject must be necessary for the completion of the VA-approved program. The candidate should be training at least one-half of the time of a post-secondary program at an educational institution to be eligible to receive assistance.
  3. VA Form 22-1990N, Application for VA Education Benefits under the National Call to Service (NCS) Program is used to apply for education benefits under the National Call to Service (NCS) program.

Individuals are eligible to apply for these benefits if they first entered service on or after October 1, 2003, signed an enlistment contract with under the NCS program, and then elected one of the two education incentives provided by the NCS

APPLICATION FOR VA EDUCATION BENEFITS
(VA FORM 22-1990)
Use this form to apply for educational assistance under the following benefit programs:
• Post- 9/11 GI Bill chapter 33 of title 38, U.S. Code
• Montgomery GI Bill (MGIB) chapter 30 of title 38, U.S. Code
• Montgomery GI Bill - Selected Reserve (MGIB-SR) chapter 1606 of title 10, U.S. Code
• Post-Vietnam Era Veterans' Educational Assistance Program (VEAP) chapter 32
of title 38, U.S. Code, or section 901 or section 903 of Public Law 96-342
INFORMATION AND INSTRUCTIONS
FOR COMPLETING THE APPLICATION FOR VA EDUCATION BENEFITS
Do not use this form to apply for Vocational Rehabilitation and Employment benefits (chapter 31 of title 38, U.S. Code), Dependents Educational
Assistance benefits (chapter 35 of title 38, U.S. Code), Marine Gunnery Sergeant John David Fry Scholarship (chapter 33 of title 38, U.S. code),
Transfer of Entitlement, or National Call to Service (section 510 of title 10, U.S. Code). These benefits require different application forms that can be
completed on-line and printed at
www.va.gov/vaforms
or can be obtained from the nearest VA regional office. They may also be available where you
received this application.
INTERNET VERSION AVAILABLE - You may complete and submit this application on-line at www.benefits.va.gov/gibill. Click "Apply
On Line" and select the "Education" option.
VA VOCATIONAL AND EDUCATIONAL COUNSELING HELP AVAILABLE - If you need help planning your individual
educational and career goals, VA offers a wide range of counseling services to help you make these decisions. Services include educational
and vocational guidance and such testing as necessary for you to develop a greater understanding of your skills, talents, and interests. For further
information on VA counseling, call VA toll-free at 1-888-GI-BILL-1 (1-888-442-4551) or TDD at the Federal Relay, 711.
PART I
Item 7. The Department of Treasury requires all Federal benefit payments be made by electronic funds transfer (EFT), also called direct deposit (Direct
Deposit is not available for Chapter 32 recipients). Please attach a voided personal check or deposit slip or provide the information requested in this
item to enroll in direct deposit. If you do not have a bank account, you must receive your payment through Direct Express Debit MasterCard. To request
a Direct Express Debit MasterCard you must apply at
www.usdirectexpress.com
or by telephone at 1-800-333-1795. If you elect not to enroll, you
must contact representatives handling waiver requests for the Department of Treasury at 1-888-224-2950. They will address any questions or concerns
you may have and encourage your participation in EFT.
NOTE: The numbers on the instructions match the item numbers on the application. Items not mentioned are self-explanatory.
This section provides an overview of the general eligibility requirements for various education programs. Additional requirements not listed on this form
may be necessary.
NOTE: A specific single period of service may not be used towards establishing eligibility for more than one benefit. Therefore, once a period of
service has been applied toward a specific benefit, that period of service may not be used again toward a different benefit. However, there is one
exception to this rule. With regard to Chapter 33, a period of service beginning before August 1, 2011, can be used to establish eligibility to Chapter 33
even if it has already been used to establish eligibility to a different benefit.
PART II
ITEM 9A. You may be eligible for benefits under the Post-9/11 GI Bill, also referred to as chapter 33, if you served at least 90 aggregate
days on active duty (excluding entry level and skill training) after September 10, 2001. You may also qualify if you were discharged due to
a service-connected disability after serving at least 30 continuous days on active duty after September 10, 2001.
ITEM 9B. You may be eligible for the Montgomery GI Bill, also referred to as MGIB or chapter 30, if you served on active duty and meet certain
conditions. NOTE: You do not have to be on active duty to apply for benefits under this program. You must meet any one of the following conditions
(there are additional requirements):
You first entered service on or after July 1, 1985, and you didn't decline this benefit at your initial entry into service
OR
You entered service (or agreed to delayed entry) before January 1, 1977, and you have educational assistance entitlement remaining under
the Vietnam Era GI Bill (also known as "chapter 34")
OR
You were voluntarily separated under the Voluntary Separation Incentive (VSI) or Special Separation Benefit (SSB) programs and had
your military pay reduced by $1,200
OR
You were involuntarily separated from active duty after February 2, 1991
OR
You were on active duty and a participant in the Post-Vietnam Era Veterans' Educational Assistance Program (VEAP) program on or before October 9,
1996, or you first entered the National Guard under title 32, U.S. Code, between July 1, 1985, and November 28, 1989, you elected chapter 30 benefits
between October 9, 1996, and October 8, 1997, and you paid $1,200
OR
You were on active duty and eligible for VEAP benefits on October 9, 1996, you elected chapter 30 benefits between November 1, 2000,
and October 31, 2001, and you paid $2,700.
VA FORM
SUPERSEDES VA FORM 22-1990, NOV 2014,
22-1990
DEC 2016
WHICH WILL NOT BE USED.
APPLICATION FOR VA EDUCATION BENEFITS
(VA FORM 22-1990)
Use this form to apply for educational assistance under the following benefit programs:
• Post- 9/11 GI Bill chapter 33 of title 38, U.S. Code
• Montgomery GI Bill (MGIB) chapter 30 of title 38, U.S. Code
• Montgomery GI Bill - Selected Reserve (MGIB-SR) chapter 1606 of title 10, U.S. Code
• Post-Vietnam Era Veterans' Educational Assistance Program (VEAP) chapter 32
of title 38, U.S. Code, or section 901 or section 903 of Public Law 96-342
INFORMATION AND INSTRUCTIONS
FOR COMPLETING THE APPLICATION FOR VA EDUCATION BENEFITS
Do not use this form to apply for Vocational Rehabilitation and Employment benefits (chapter 31 of title 38, U.S. Code), Dependents Educational
Assistance benefits (chapter 35 of title 38, U.S. Code), Marine Gunnery Sergeant John David Fry Scholarship (chapter 33 of title 38, U.S. code),
Transfer of Entitlement, or National Call to Service (section 510 of title 10, U.S. Code). These benefits require different application forms that can be
completed on-line and printed at
www.va.gov/vaforms
or can be obtained from the nearest VA regional office. They may also be available where you
received this application.
INTERNET VERSION AVAILABLE - You may complete and submit this application on-line at www.benefits.va.gov/gibill. Click "Apply
On Line" and select the "Education" option.
VA VOCATIONAL AND EDUCATIONAL COUNSELING HELP AVAILABLE - If you need help planning your individual
educational and career goals, VA offers a wide range of counseling services to help you make these decisions. Services include educational
and vocational guidance and such testing as necessary for you to develop a greater understanding of your skills, talents, and interests. For further
information on VA counseling, call VA toll-free at 1-888-GI-BILL-1 (1-888-442-4551) or TDD at the Federal Relay, 711.
PART I
Item 7. The Department of Treasury requires all Federal benefit payments be made by electronic funds transfer (EFT), also called direct deposit (Direct
Deposit is not available for Chapter 32 recipients). Please attach a voided personal check or deposit slip or provide the information requested in this
item to enroll in direct deposit. If you do not have a bank account, you must receive your payment through Direct Express Debit MasterCard. To request
a Direct Express Debit MasterCard you must apply at
www.usdirectexpress.com
or by telephone at 1-800-333-1795. If you elect not to enroll, you
must contact representatives handling waiver requests for the Department of Treasury at 1-888-224-2950. They will address any questions or concerns
you may have and encourage your participation in EFT.
NOTE: The numbers on the instructions match the item numbers on the application. Items not mentioned are self-explanatory.
This section provides an overview of the general eligibility requirements for various education programs. Additional requirements not listed on this form
may be necessary.
NOTE: A specific single period of service may not be used towards establishing eligibility for more than one benefit. Therefore, once a period of
service has been applied toward a specific benefit, that period of service may not be used again toward a different benefit. However, there is one
exception to this rule. With regard to Chapter 33, a period of service beginning before August 1, 2011, can be used to establish eligibility to Chapter 33
even if it has already been used to establish eligibility to a different benefit.
PART II
ITEM 9A. You may be eligible for benefits under the Post-9/11 GI Bill, also referred to as chapter 33, if you served at least 90 aggregate
days on active duty (excluding entry level and skill training) after September 10, 2001. You may also qualify if you were discharged due to
a service-connected disability after serving at least 30 continuous days on active duty after September 10, 2001.
ITEM 9B. You may be eligible for the Montgomery GI Bill, also referred to as MGIB or chapter 30, if you served on active duty and meet certain
conditions. NOTE: You do not have to be on active duty to apply for benefits under this program. You must meet any one of the following conditions
(there are additional requirements):
You first entered service on or after July 1, 1985, and you didn't decline this benefit at your initial entry into service
OR
You entered service (or agreed to delayed entry) before January 1, 1977, and you have educational assistance entitlement remaining under
the Vietnam Era GI Bill (also known as "chapter 34")
OR
You were voluntarily separated under the Voluntary Separation Incentive (VSI) or Special Separation Benefit (SSB) programs and had
your military pay reduced by $1,200
OR
You were involuntarily separated from active duty after February 2, 1991
OR
You were on active duty and a participant in the Post-Vietnam Era Veterans' Educational Assistance Program (VEAP) program on or before October 9,
1996, or you first entered the National Guard under title 32, U.S. Code, between July 1, 1985, and November 28, 1989, you elected chapter 30 benefits
between October 9, 1996, and October 8, 1997, and you paid $1,200
OR
You were on active duty and eligible for VEAP benefits on October 9, 1996, you elected chapter 30 benefits between November 1, 2000,
and October 31, 2001, and you paid $2,700.
VA FORM
SUPERSEDES VA FORM 22-1990, NOV 2014,
22-1990
DEC 2016
WHICH WILL NOT BE USED.
ITEM 9C. You may be eligible for the Montgomery GI Bill - Selected Reserve Educational Assistance Program, also known as MGIB-SR or chapter
1606, if you are a member of the Selected Reserve and meet certain requirements, including a 6-year commitment. (The Departments of Defense and
Homeland Security determine eligibility for this program.)
To expedite processing, attach a copy of your DD 2384, Selected Reserve Educational Assistance Program (GI BILL) Notice of Basic Eligibility. This
form is also called a "NOBE." Your reserve unit should have issued this notice to you when you became eligible for the Montgomery GI Bill - Selected
Reserve Educational Assistance Program. If you are unable to locate your copy, request a duplicate from your reserve unit.
ITEM 9D. You may be eligible for benefits under the Post-Vietnam Era Veterans' Educational Assistance Program (VEAP), also known as Chapter 32,
if your service began on or after January 1, 1977, and before July 1, 1985, and you contributed to a VEAP account.
You may be eligible for benefits under the Post-Vietnam Era Non-Contributory Veterans' Educational Assistance Program, also known as "Non-
Contributory VEAP" or Section 903", if your service began on or after November 30, 1980, and before October 1, 1981, and your branch of service paid
contributions into your VEAP account.
ITEM 9E. If you are eligible for MGIB, MGIB-SR, OR REAP, you must elect to give up eligibility under the program for which you are eligible in
order to receive benefits under the Post-9/11 GI Bill (chapter 33). If you are eligible for more than one of the programs listed (MGIB, MGIB-SR, and
REAP), you are only required to give up one of the programs for which you are eligible in order to receive benefits under the Post-9/11 GI Bill. You may
not receive more than a total of 48 months of benefits under two or more programs. If you elect chapter 33 in lieu of MGIB, MGIB-SR, or REAP and
you have used MGIB in the past, your months of entitlement under chapter 33 will be limited to the number of months of entitlement remaining under
the relinquished chapter 30 benefit on the effective date of your election. If you wish to elect to receive benefits under the Post-9/11 GI Bill, check the
box next to the program (only check one box) you are giving up.
NOTE: An election to give up benefits under an existing program and receive benefits under the Post-9/11 GI Bill is IRREVOCABLE. You should
carefully consider your decision before completing this section. If you need more information to make a choice, you should visit our website at
www.benefits.va.gov/gibill
or call our toll-free customer service number at 1-888-GIBILL-1 (1-888-442-4551).
PART III
ITEM 10A. Self-explanatory, except for the following items:
"Vocational Flight Training." You must already have a private pilot's license. If you are taking an Airline Transport Pilot course, you must have a valid
first-class medical certificate on the date that you enter training. For all other flight courses, you must have a valid second-class medical certificate on the
date that you enter training.
"National Test Reimbursement." You can be reimbursed for the cost of approved tests for admission to, or credit at, institutions of higher learning.
"Licensing or Certification Test Reimbursement." A licensing test is a test offered by a state, local, or federal agency that is required by law to practice
an occupation. A certification test is a test designed to provide affirmation of an individual's qualifications in a specific occupation. Examples include
EMT, CPA, MCSE, CCNP, etc.
"Tuition Assistance Top-Up." This benefit is payable only under MGIB and the Post-9/11 GI Bill programs. You can receive benefits to pay for the
difference between what the military pays with Tuition Assistance (TA) and the total costs of these courses.
PART VIII
QUESTIONS ARE ONLY FOR APPLICANTS WHOSE SERVICE BEGAN BEFORE JANUARY 1, 1977, (or delayed entry before January 2, 1978). If
you are currently married or if you have children under age 18 (under age 23 if in school), you should complete and return VA Form 21-686c. If your
children are in school, you should also complete and return VA Form 21-674 for each child. If your parent(s) are dependent on you for financial support,
you should complete and return VA Form 21-509. These forms may require additional documentation. VA cannot pay any additional benefits for
dependents without properly completed forms and documentation. You can find VA forms 21-686c, 21-674, and 21-509 on-line at www.va.gov/vaforms.
ITEM 24. If you are certifying that you are married for the purpose of VA benefits, your marriage must be recognized by the place where you and/or
your spouse resided at the time of marriage, or where you and/or your spouse resided when you filed your claim (or a later date when you became
eligible for benefits) (38 U.S.C. § 103(c)). Additional guidance on when VA recognizes marriages is available at www.va.gov/opa/marriage.
ADDITIONAL HELP
If you need more help in completing this application, call VA TOLL FREE at 1-888-GI-BILL-1 (1-888-442-4551). If you use the Telecommunications
Device for the Deaf (TDD), the Federal Relay number is 711. You can also get education assistance after normal business hours at our education Internet
site www.benefits.va.gov/gibill.
HOW TO FILE YOUR CLAIM
Be sure to do the following:
(A) If you have selected a school or training establishment:
Step 1. Mail the completed application to the VA Regional Processing Office for the region of that school's physical address. See next page for the
addresses of these VA Regional Processing Offices.
Step 2. Tell the veterans certifying official at your school or training establishment that you have applied for VA education benefits. Ask him or her to
send your enrollment information using VA Form 22-1999, Enrollment Certification, or its electronic version.
Step 3. Wait for VA to process your application and notify you of its decision concerning your eligibility for education benefits.
VA FORM 22-1990, DEC 2016
(B) If you haven't selected a school or training establishment:
Step 1: Mail the completed application to the VA Regional Processing Office for the region of your home address. See the addresses below of these VA
Regional Processing Offices.
Step 2: Wait for VA to process your application and notify you of its decision concerning your eligibility for education benefits.
Eastern Region:
Western Region:
VA Regional Office
VA Regional Office
P. O. Box 4616
P. O. Box 8888
Buffalo, NY 14240-4616
Muskogee, OK 74402-8888
SERVES THE FOLLOWING STATES
SERVES THE FOLLOWING STATES
CT
DE
DC
MA
AK
AL
AR
AZ
MD
ME
NC
NH
CA
FL
GA
HI
NJ
PA
RI
NY
LA
MS
ID
NM
US Virgin
Foreign
VA
VT
Islands
Schools
PR
NV
OR
OK
APO/FPO AA
SC
TX
UT
WA
APO/FPO AP
Guam
Philippines
Central Region:
VA Regional Office
P. O. Box 32432
St. Louis, MO 63132-0832
SERVES THE FOLLOWING STATES
CO
IA
IL
IN
KS
KY
MI
MN
MO
MT
NE
ND
OH
SD
TN
WV
WI
WY
Privacy Act Notice: The VA will not disclose information collected on this form to any source other than what has been authorized under the Privacy Act of 1974 or title
38, Code of Federal Regulations, section 1.576 for routine uses (e.g., VA sends educational forms or letters with a veteran's identifying information to the veteran's school
or training establishment to (1) assist the veteran in the completion of claims forms or (2) for the VA to obtain further information as may be necessary from the school for
the VA to properly process the veteran's education claim or to monitor his or her progress during training) as identified in the VA system of records, 58VA21/22/28,
Compensation, Pension, Education, and Vocational Rehabilitation and Employment Records - VA, and published in the Federal Register. Your obligation to respond is
required to obtain or retain education benefits. Giving us your SSN account information is voluntary. Refusal to provide your SSN by itself will not result in the denial of
benefits. The VA will not deny an individual benefits for refusing to provide his or her SSN unless the disclosure of the SSN is required by a Federal Statute of law enacted
before January 1, 1975, and still in effect. The requested information is considered relevant and necessary to determine the maximum benefits under the law. While you do
not have to respond, VA cannot process your claim for education assistance unless the information is furnished as required by existing law (38 U.S.C. 3471). The responses
you submit are considered confidential (38 U.S.C. 5701). Any information provided by applicants, recipients, and others may be subject to verification through computer
matching programs with other agencies.
Respondent Burden: We need this information to determine your eligibility for education benefits (38 U.S.C. 3471). Title 38, United States Code, allows us to ask for this
information. We estimate that you will need an average of 15 minutes to review the instructions, find the information, and complete this form. VA cannot conduct or sponsor
a collection of information unless a valid OMB (Office of Management and Budget) control number is displayed. You are not required to respond to a collection of
information if this number is not displayed. Valid OMB control numbers can be located on the OMB Internet Page at www.reginfo.gov/public/do/PRAMain. If desired, you
can call 1-800-827-1000 to get information on where to send comments or suggestions about this form.
VA FORM 22-1990, DEC 2016
OMB Control No. 2900-0154
Respondent Burden: 15 minutes
Expiration Date: 12/31/2019
APPLICATION FOR VA EDUCATION BENEFITS
(See attached Information and Instructions)
INTERNET VERSION AVAILABLE - You may complete and send your application over the Internet at:
www.benefits.va.gov/gibill.
PART I - APPLICANT INFORMATION
1. SOCIAL SECURITY NUMBER OF APPLICANT
2. SEX OF APPLICANT
3. APPLICANT'S DATE OF BIRTH
Month
Day
Year
MALE
FEMALE
4. NAME (First, Middle Initial, Last)
5. APPLICANT'S ADDRESS
Number and Street
Apt./Unit Number
City, State, ZIP Code
6A. APPLICANT'S TELEPHONE NUMBERS (Include Area Code)
Primary:
Secondary:
6B. APPLICANT'S E-MAIL ADDRESS (Required)
7. DIRECT DEPOSIT (Attach a voided personal check or provide the following information. Direct Deposit is not available for Chapter 32 recipients. See instructions for additional Direct
Deposit information.)
Routing or Transit Number
Account Type
Account Number
Checking
Savings
8. PLEASE PROVIDE THE NAME, ADDRESS, AND PHONE NUMBER OF SOMEONE WHO WILL ALWAYS KNOW WHERE YOU CAN BE REACHED
A. NAME
B. ADDRESS
C. PHONE NUMBER
PART II - EDUCATION BENEFITS BEING APPLIED FOR
For help with completing this section, please see the attached instructions page or visit our website at
www.benefits.va.gov/gibill
9A. Chapter 33 - Post-9/11 GI Bill (After checking this box, check and complete Item 9E, if you are receiving, or if you are eligible for benefits under Chapter 30,
Chapter 1606, or Chapter 1607).
9B. Chapter 30 - Montgomery GI Bill Educational Assistance Program (MGIB)
9C. Chapter 1606 - Montgomery GI Bill - Selected Reserve Educational Assistance Program (MGIB-SR)
9D. Chapter 32 or Section 903 - Post-Vietnam Era Veterans' Educational Assistance Program (VEAP)
9E. By electing Chapter 33 in Item 9A, I acknowledge that I understand the following:
• I may not receive more than a total of 48 months of benefit entitlement under two or more of the education programs listed on this application.
• If electing Chapter 33, in lieu of Chapter 30, my months of entitlement under Chapter 33 will be limited to the number of months of entitlement
remaining under Chapter 30 on the effective date of my election.
• I will not receive a Montgomery GI Bill (Active Duty-Chapter 30 or Selected Reserve-Chapter 1606) "Kicker" under the Post-9/11 GI Bill, unless
I was eligible for the kicker at the time I applied and I relinquished that benefit for the Post-9/11 GI Bill-Chapter 33.
• When choosing the effective date below, I understand that benefits for training under Chapter 33 are not payable prior to that date.
ACKNOWLEDGEMENT: I elect to receive Chapter 33 education benefits effective
, in lieu of the education benefit
checked below.
(Date)
By checking the box below, I am acknowledging that I understand that this election is irrevocable and may not be changed, and that failure to check
one of the boxes below may cause a delay in the processing of this claim. (PLEASE CHECK ONLY ONE BOX FOR THE BENEFIT YOU
RELINQUISH FOR CHAPTER 33.)
You MUST check only one box below:
Chapter 30 - Montgomery GI Bill Educational Assistance Program (MGIB)
Chapter 1606 - Montgomery GI Bill - Selected Reserve Educational Assistance Program (MGIB-SR)
VA DATE STAMP
(Do Not Write In This Space)
Chapter 1607 - Reserve Educational Assistance Program (REAP). (You are only eligible to relinquish 1607
if you received 1607 benefits for a semester, quarter or term that included the date of November 24, 2015, or was
the last semester, quarter or term to end prior to November 24, 2015)
VA FORM
22-1990
SUPERSEDES VA FORM 22-1990, NOV 2014,
PAGE 1 OF 4
DEC 2016
WHICH WILL NOT BE USED.
SOCIAL SECURITY NUMBER OF APPLICANT
PART III - TYPE AND PROGRAM OF EDUCATION OR TRAINING
10A. TYPE OF EDUCATION OR TRAINING (See instructions for additional information)
COLLEGE OR OTHER SCHOOL (Including on-line courses)
APPRENTICESHIP OR ON-THE-JOB
VOCATIONAL FLIGHT TRAINING
CORRESPONDENCE
NATIONAL TEST REIMBURSEMENT (SAT, CLEP, ETC.)
TUITION ASSISTANCE TOP-UP
(Chapter 30 & 33 only)
LICENSING OR CERTIFICATION TEST REIMBURSEMENT
(MCSE, CCNA, EMT, NCLEX, ETC.)
10B. PROVIDE THE FULL NAME AND ADDRESS OF THE SCHOOL, IF KNOWN (Skip this item if you are only applying for National Test Reimbursement, Licensing and
Certification Test Reimbursement, or Tuition Assistance Top-Up)
10C. PLEASE SPECIFY YOUR EDUCATIONAL OR CAREER OBJECTIVE, IF KNOWN (e.g. Bachelor of Arts in Accounting, welding certificate, police officer, etc.)
PART IV - SERVICE INFORMATION
NOTE: It will help VA process your claim if you send a copy of the following:
• DD Form 214 (Member 4) for all periods of active duty service (excluding active duty for training)
• DD Form 2384, Notice of Basic Eligibility (NOBE) if applying for Chapter 1606
• Copies of orders if activated from the Guard/Reserves
11. ARE YOU ON ACTIVE DUTY? (Do not check "Yes" if you are currently on drilling status in the Selected Reserve, or if you are on active duty for training)
YES
NO
12. ARE YOU NOW ON TERMINAL LEAVE JUST BEFORE DISCHARGE?
(Please provide a copy of your DD Form 214 (Member 4) when issued)
YES
NO
13. PLEASE COMPLETE THE FOLLOWING FOR EACH PERIOD OF MILITARY SERVICE
C. SERVICE COMPONENT (USN,
D. SERVICE STATUS (Active duty,
E. WERE YOU INVOLUNTARILY CALLED TO
A. DATE ENTERED
B. DATE SEPARATED
USAF, USAR, ARNG, etc.)
drilling reservist, IRR, etc.)
ACTIVE DUTY FOR THIS PERIOD?
EXAMPLES
9/26/2000
9/24/2004
USMC
NO
ACTIVE DUTY
1/18/2005
8/14/2007
USMCR
DRILLING
N/A
14. VA will assume that you want us to apply every period of service that you have identified in Item 13 above to the single, specific benefit you are
applying for in Part II (the benefit chosen between Items 9A thru 9D). However, if there are specific periods of service that you do not want applied to the
benefit selected in Part II (Items 9A thru 9D), then please identify in the space below the periods of service and the corresponding benefit program(s) to
which you would like them applied.
NOTE: A specific single period of service may not be used towards establishing eligibility for more than one benefit. Therefore, once a period of
service has been chosen and applied toward a specific benefit, that period of service may not be used again toward a different benefit. However, there
is one exception to this rule. With regard to Chapter 33, a period of service beginning before August 1, 2011, can be used to establish eligibility to
Chapter 33 even if it has already been used to establish eligibility to a different benefit.
PART V - EDUCATION AND EMPLOYMENT INFORMATION
15A. DID YOU RECEIVE A HIGH SCHOOL DIPLOMA OR HIGH SCHOOL
15B. DO YOU HOLD ANY FAA FLIGHT CERTIFICATES? (If "Yes," specify each
EQUIVALENCY CERTIFICATE? (If "Yes" provide date)
certificate in Part IX, Remarks)
YES
DATE:
NO
YES
NO
VA FORM 22-1990, DEC 2016
PAGE 2 OF 4

Download VA Form 22-1990 Application for VA Education Benefits

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