Application for Tuition Assistance for Certain War Veterans' Children - South Carolina

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Application   f or   T uition   A ssistance  
 
South   C arolina                                                                
for   C ertain   W ar   V eterans’   C hildren  
 
Division   o f   V eterans’   A ffairs  
 
(Title   5 9-­‐111-­‐20,   1 976   C ode   o f   L aws   o f   S outh   C arolina   a s   a mended)  
 
Check   o ne:  
[           ]   I nitial   A pplication    
[           ]   R esubmitted   A pplication  
 
Part   O ne:     S tudent   I nformation  
 
Last   N ame:  
First   N ame:  
Middle   I nitial:  
 
Social   S ecurity   N umber:  
Date   o f   B irth:  
 
Address:  
 
City:  
State:  
Zip   C ode:  
 
Number   o f   Y ears/Months   a t   c urrent   r esidence:  
Telephone   N umber:  
Has   s tudent   r eceived   a   H igh   S chool   D iploma,   G ED,   o r   e quivalent?      
1
Relationship   b etween   V eteran   a nd   S tudent
:     ( Please   c hoose   o ne)            
 
                                                                                                   
                                                                        C hild/Step   C hild                                                                                     A dopted   C hild   ( please   g ive   d ate   o f   a doption)  
Please   l ist   t he   n ames   a nd   s ocial   s ecurity   n umbers   o f   a ny   s iblings   w ho   h ave   b een   p reviously   a pproved   b y   t he   p rogram   t o   s peed  
processing   o f   t his   a pplication:  
 
1  
Please   s ubmit   o ne   o f   t he   f ollowing   w ith   t he   a pplication:   ( 1)   a   c opy   o f   t he   S tudent’s   b irth   c ertificate   s howing   t he   V eteran   p arent’s   f ull   n ame,   ( 2)   t he   S tudent’s   b irth  
certificate   w ith   p arents’   f ull   n ames   a nd   a   c opy   o f   t he   m arriage   l icense   s howing   t he   V eteran   i s   m arried   t o   o ne   o f   t he   S tudent’s   p arents,   o r   ( 3)   a   c opy   o f   t he   c ompleted  
adoption   p aperwork   s howing   t he   S tudent’s   a nd   V eteran’s   f ull   n ames.  
 
Part   T wo:     S chool   I nformation  
 
2
Name   o f   C ollege,   U niversity   o r   T echnical   C ollege   S tudent   w ill   a ttend
:  
Location   o f   C ampus:  
 
2  
Student   m ust   h ave   b een   a ccepted   a nd   p lan   t o   a ttend   t he   s tate   s upported   i nstitution   l isted   o n   t his   a pplication  
 
Part   T hree:     V eteran   I nformation  
 
Last   N ame:  
First   N ame:  
Middle   I nitial:  
 
Social   S ecurity   N umber:  
VA   C laim   N umber:  
 
Address:  
 
City:  
State:  
Zip   C ode:  
 
Number   o f   Y ears/Months   a t   c urrent   r esidence:  
Telephone   N umber:  
 
 
Dates   o f   M ilitary   S ervice:  
Character   o f   S ervice:  
 
 
 
SOUTH CAROLINA DIVISION OF VETERANS’ AFFAIRS
VA REGIONAL OFFICE
6437
1126
29209
GARNERS FERRY ROAD, SUITE
, COLUMBIA, SOUTH CAROLINA,
803.647.2434
803.647.2312
PHONE
FAX
WWW.VA.SC.GOV  

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