Student ID Number

Indicate applicable chapter:

CHAP 30 (MGIB)
CHAP 33 (Post 9/11 - Transfer of Entitlement - Dependent)
CHAP 31 (Vocational Rehabilitation)
CHAP 1607 (REAP)
CHAP 1606 (National Guard)
CHAP 35 (Dependent Education Assistance)
Fry Scholarship
Other

Last Name

First Name

Telephone

Email Address

Mailing Address (Number and Street, City, State, Zip)

Prior School Attended

WCU Major

For which semester are you applying?

Spring 2013
Summer 2013
Fall 2013
Spring 2014