Military Benefits Notification Form - Enrollment Data Form Students who are eligible for veterans or military benefits must self-disclose their eligibility to the Rockhurst University Student Accounts Office prior to the payment due date to avoid a late payment fee. A late fee will only be assessed if we do not know of a pending VA payment. Please note: This form is only open for the current term. This form will open for future terms after the bills are available for that term. You cannot complete this form before the bills open for a future term.Loading...Your enrollment certification cannot be submitted to the VA until the School Certifying Official receives an accurately completed form.Term (If you are not enrolled for the term selected this form will not be processed)Spring 2026Rockhurst Student ID (example: @00123456) Please enter @00 and your six digit ID numberBirthdateBirthdateJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember12345678910111213141516171819202122232425262728293031202520242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900Full SSN (no dashes)Expected Graduation DateFirst NameLast NameEmail AddressPhone NumberWhat is your major?Accelerated NursingAccountingMSNAnalytics and TechnologyApplied MathematicsBachelor of Science in NursingBachelor of Science in Nursing (RN to BSN Health System Employees)Bachelor of Science in Nursing (RN to BSN)BiochemistryBiologyBiology (Molecular)Biology (Organismal)Business AdministrationBusiness CommunicationChemistryCommunicationComputer ScienceCorporate Finance/AccountingCriminal JusticeCSD/Speech PathologyDPTEconomicsEducation (Elementary)Education (Secondary)Education (Special)EDDEngineeringEngineering, BiomedicalEngineering, CivilEngineering, ElectricalEngineering, MechanicalEnglishEnglish (Film)English (Literature)English (Writing)Exercise ScienceFinancial ManagementFinancial Markets and Economic AnalysisFrenchFundraising Leadership StudiesGlobal StudiesHealth SciencesHistoryInformation TechnologyInternational BusinessManagementMarketingMarketing AnalyticsMaster of Science in Nursing (Adult Gerontology Acute Care Nurse Practitioner)Master of Science in Nursing (Family Nurse Practitioner Second Masters)Master of Science in Nursing (Family Nurse Practitioner)Master of Science in Nursing (Generic)Master of Science in Nursing (Nurse Educator)Materials ScienceMathematicsMBAMEDMedical Laboratory SciencesNonprofit LeadershipNursingOTDPhilosophyPhilosophy (Bioethics)Philosophy (Professional)Philosophy (Social Justice)PhysicsPhysics of MedicinePolitical SciencePre-DentistryPre-LawPre-MedicinePre-NursingPre-Occupational TherapyPre-OptometryPre-PharmacyPre-Physical TherapyPre-Physician's AssistantPre-Veterinary MedicinePsychologyPublic PolicySpanishSports ManagementStrategic CommunicationTheology and Religious StudiesStill DecidingWhat is your military status?VeteranDependent of a VeteranSpouse of a VeteranActive DutyReserveWhat is the percentage of eligible payable benefits?VA Education BenefitsActive DutyCHAPTER 30 - Montgomery G.I. BillCHAPTER 31 - Vocational RehabilitationCHAPTER 35 - Survivors' & Dependents' Educational Assistance ProgramCHAPTER 33 - Post 9/11 G.I. BillCHAPTER 1606CHAPTER 1607ArmyIgnited TAMissouri National GuardOtherI am aI am aMilitary ServicememberDependent of a Military ServicememberIf the servicemember is a parent or spouse, please enter their full name. This is requested by the VA during school certification. If you are the military servicemember please type NA.If the servicemember is a parent or spouse, please enter their SSN#. This is requested by the VA during school certification. If you are the military servicemember please type NA.If using Chapter 31 please enter the PO# (purchase order number) given to you by your VA rep:Please attach your Certificate of Eligibility.Reminder about Dropping Courses: Please notify the Certifying Official if you add or drop hours. When you drop a class and your credit hours change, we report your new enrollment information to the VA. It is your responsibility to notify us of any changes to your enrollment. This change could result in a debt owed to the VA depending on when in the semester you dropped the course. Please contact the Ask a Question https://www.gibill2.va.gov or GI Bill Education Call Center (1.888.442.4551) for specific questions about creating a debt, or the Certifying Official to know how we will report the dropped class to the VA.For more information on VA programs or for benefits rate information, visit the VA website: http://www.gibill.va.gov.Submit