Application For The Benefit Of Paying In-State Tuition As A Veteran Or Spouse / Dependent Of A Veteran Or Former Service Member Or Other Covered Individuals Using Transfered Chapter 33 Page 2

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Applicant’s Full Name: __________________________________________________________________  
  
UNC E‐mail Address: ____________________________________   UNC PID: ______________________  
  
Mailing Address: _______________________________________________________________________  
  
City: _________________________________       State: ________  
    Zip Code: __________  
  
  
For applicants who will be a veteran or who are the spouse or dependent relative of a veteran at the 
time of enrollment (enrollment = first day of the term).  
  
1. For the veteran through whom you claim the tuition benefit, provide the following:  
 
a. Date of initial entry into military service.    _________________________________ 
  
b. Discharge or retirement date.    _________________________________ 
  
2. Do you currently live in North Carolina or will you be living in North Carolina on the first day of 
the term?      
 
               Yes                       No  
  
If yes, please attach PROOF OF ABODE IN NORTH CAROLINA.  Proof of abode includes, but is 
not limited to:  copy of lease, a letter from landlord, copy of utility bill, or verification of on 
campus housing.    
    
3. Have you been academically admitted to this institution?      
 
               Yes                        No  
  
4. Beginning with what academic term are you seeking the tuition benefit? Semester:   
           
                Fall                       Spring                         Summer                Other    __________        
 
                Year:     __________ 
  
5. Are you eligible for and will you be using transferred Chapter 33 (Post‐9/11 Educational 
Assistance) U.S. Department of Veterans Affairs benefits or the Marine Gunnery Sergeant John 
David Fry Scholarship?              
 
                 Yes                       No  
  
If yes, please attach VA verification of TRANSFER OF POST 9/11 GI BILL BENEFITS (Transfer of 
Entitlement) or FRY SCHOLARSHIP AWARD.  
  
Page 2  
  
July 31, 2015  
  

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