POST 9/11 Yellow Ribbon Program Election Form

For consideration of the Yellow Ribbon Benefit Program, the student must provide a copy of the certificate of eligibility (COE), which is issued by the Department of Veteran Affairs. The certificate or award letter must declare the student as eligible for the maximum benefit rate (100%) under the Chapter 33 Post 9/11 GI Bill and Yellow Ribbon Program benefit.

Name:
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Blazer ID:
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City:
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State:
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Phone:
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E-Mail Address
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Status

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Do you anticipate being enrolled full time for the fall and spring terms?
Undergraduate: Full time enrollment constitutes 12 hours
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Summer term?
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Have you applied for the Post 9/11 GI Bill Chapter 33 education benefits through VONAPP?
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Have you been declared by Veterans Affairs as 100% eligible to receive the Post 9/11 GI Bill?
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Are you receiving active duty benefits?
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Effective date for benefit:
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Months of entitlement for the benefit:
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Are you receiving transfer of entitlement benefits?
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If so, as:
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I understand my election of the Chapter 33 Post 9/11 GI Bill is an irrevocable and final decision.
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I recognize my eligibility for the Yellow Ribbon Program is contingent upon maintaining good academic standing and continuous enrollment at the University of Alabama at Birmingham.
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I acknowledge my responsibility for any outstanding balance not covered by the Chapter 33 Post 9/11 GI Bill, Yellow Ribbon Program, other financial aid or loans. The amount of Post 9/11 and Yellow Ribbon benefits are not finalized until completion of registration each term.
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Please type in the following characters:
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By clicking submit, you confirm that you have read the terms of the benefit as provided by the Department of Veteran Affairs and the University of Alabama at Birmingham. I understand the Yellow Ribbon Program is an annual agreement between the VA and the University of Alabama at Birmingham and the terms are subject to change each academic year.