Piedmont College
Veteran’s Education Benefits Request Form
First Name Last Name Address 1 Address 2 City State Zip Code Email Date of Birth Campus Program of Study: (If your program of study changes, you must notify the School Certifying Official.) By submitting this form, I am requesting that Piedmont College’s School Certifying Official (SCO)certify me for my VA Education Benefits. I have an e-Benefits premium account and have submitted
necessary paperwork to the Department of Veterans Services. If I make any changes with my schedule, I'll notify the SCO of any changes. I am aware that changes in my schedule could result in a debt to the he Department of Veterans Services. I am responsible for payment of tuition that is not covered by my benefit and not covered by financial aid.
Veteran Status Date: