CT State Vets Tuition Waiver application Application for the waiving of tuition or the equivalent at the University of Connecticut and its regional campuses. "*" indicates required fields Date* Month Day Year Section 1 - Student InformationStudent IDEnter your UCONN Student ID (7 digits) This can be found on your UConn ID. UCONN Email Address Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Cell Phone Number*Home PhoneDomicile*On the date of your acceptance letter, where you living in Connecticut, or if you were on Active Duty in the United States Armed Forces, was Connecticut your home of residence? (Did CT show as your state of residence on your LES.)YesNoNot EligibleBased on the answer you have given to the last question, you may not be eligible for the CT State Veterans Tuition Waiver as you have indicated you were not domiciled in CT at the time of acceptance into your program. You may be eligible for other benefits, Please contact this office if you have any questions and/or would like a review of your possible benefits.Vehicle*Do you own or lease a vehicle that is registered in the State of Connecticut?YesNoDo you have a current, valid Connecticut Driver's Liscense?*YesNoStationed in CT*Are you or your spouse stationed in CT under Military Orders?YesNoSection 2 - Program InformationUConn Campus*Please select the UConn Campus to which you were admitted. StorrsAvery PointHartfordMBA - HartfordMBA - StamfordSchool of LawSchool of Social WorkStamfordWaterburyMajor/Minor/Certificate*Educational Goal - (Major/Minor - if applicable) or Certificate concentration Program Type*Select the program type that applies.Undergraduate (Not BGS or ACES)BGSACESTCPCGCEINLAWMBA (including EMBA and PMBA)LAWGraduateCertificateSemesters*Please chose the semesters you are planning on using the waiver.SpringFallSummerWinterWhy are you applying for the waiver?*Please pick all those that applyMy GI BIll (CH30 Montgomery and Post 9/11) is less than 100%Summer/Winter intersession use onlyNot using/Saving/Exhausted GI Bill BenefitsOther - Please explain in box belowReason for waiver applicationMilitary ServiceMilitary Affiliation*Please select your military affiliation. If you have more than one, please select the most recent.ArmyAir ForceNavyMarinesCoast GuardArmy ReservesAir Force ReserveNavy ReserveMarine ReserveCoast Guard ReserveArmy National GuardAir National GuardRank*Please select your rank - If you have more than one, please select the most recent.EnlistedWarrantCommissioned OfficerQualifying Service*Only Active Duty service or Engagement in combat or a direct combat support role during certain periods of conflict are eligible for the waiver. Please select your qualifying period(s) of service. WWII -Decemeber 7th, 1941 to December 31st, 1946Korean Hostilities - June 27th, 1950 to January 31st, 1955Vietnam - Febuary 28th, 1961 to July 1st, 1975Persian Gulf Era - August 2, 1990 to PresentLebanon Conflict - July 1st, 1958 to November 1st, 1958Lenanon Peace Keeping mission - September 29th, 1982 to March 30th, 1984Grenada Invasion - October 25th, 1983 - December 15th, 1983Operation Earnest Will - July 24th, 1987 - August 1,st, 1980Panama Invasion - December 20th, 1989 - January 31, 1990None of the aboveDirect Combat or Combat Support roleYou have selected a period of qualifying service that requires Combat or a Direct Combat Support role. As these periods of service require engagement in combat or a Direct Combat Support role, you may be required to submit supporting documentation in addition to your DD-214. Such documentation may include Campaign Medals, Military Deployment Orders, and Campaign Ribbons. Any documentation that shows a Direct Combat Support role or Combat role can be submitted for review. Please give a short description of the documents you are submitting below.Not EligibleBased on the answer you have given to the last question, you may not be eligible for the CT State Veterans Tuition Waiver as you have indicated that you have not served during a qualifying period. You may be eligible for other benefits, Please contact this office if you have any questions and/or would like a review of your possible benefits.DD-214*Can you provide an original DD-214 (Member 2, Service 4 or Service 7) copy showing 90 days of Active Duty Service, and a General (Under Honorable Conditions) or Honorable discharge? Time in the Service Academies, IADT (Boot Camp and Tech, AIT schools), annual training or Drill weekends do not count towards the 90 day requirement. If you cannot provide a supporting DD-214, we cannot normally establish your eligibility for the waiver. If you believe there are extenuating circumstances, have recently or are about to separate from the Military and do not have your DD-214 yet, please contact this office at email@example.com or 860-486-2442YesNoNot EligibleBased on the answer that you will NOT be able to provide a DD-214 showing the required service, you may not be eligible for the CT State Veterans Tuition Waiver. If you have lost or just cant find your DD-214, a good place to start looking for a replacement copy is https://www.archives.gov/veterans. You may be eligible for other benefits, Please contact this office if you have any questions and/or would like a review of your possible benefits.Federal VA Benefits?*Will you be using any Federal benefit this academic year?NO - I will not be using any Federal BenefitCH33 Post 9/11 GI Bill at 100%CH33 Post 9/11 GI Bill at less than 100%CH30 Montgomery GI BIll (Not National Guard or Reserve)CH 1606 MGiB Select Guard and ReserveCH 31 Vocational RehabCH 35 Dependents Educational AssistanceCH 33 Post 9/11 usage with the CT Veterans Tuition WaiverPost 9/11 (CH33)at the 100% eligibility level, and Vocational Rehab (CH31), cannot be combined with the CT Veterans Tuition Waiver. Post 9/11 (CH33), benefits at less than 100% eligibility level, as well as Montgomery GI Bill (CH30), MGiB Select Guard and Reserve, (CH1606),Dependents Educational Assistance - DEA (CH35) CAN be utilized with the CT Veterans Tuition waiver to cover the remainder of/or total of the Tuition charges on your fee bill. The combined amount cannot exceed: A: The total amount of your tuition charge B: The maximum instate tuition charge for 1: Undergraduate tuition at 12 credits 2: Graduate tuition at 9 credits as there is no additional charge for credits taken in excess of those amounts. If your program charges a Program Fee, the waiver amount will be equal to the in state per credit tuition charge multiplied by the amount of credits you are taking, up to a maximum of 12 credits for undergraduate programs and 9 credits for graduate level programs. Acknowledged Required Documentation Check ListYou must provide, along with your DD-214, at least 1 (one) document from group 1 OR 2 (two) documents from group 2 proving domicile in Connecticut for least 1 (one) day prior to the date on your acceptance letter. Please check the documents you will be providing. You can submit your DD-214 via the submission feature on this application, or you may submit a copy via e-mail to firstname.lastname@example.org. Please black out all but the last 4 of your SSN#, located in the upper right corner. NOTE: "Public Law 18-47" effective 1 OCT 18, extends the CT Veterans Tuition Waiver to certain Veterans with Other than Honorable discharge. The Veteran applying for the waiver must submit, along with the complete CT DVA OTH Form 1, all other required documentation (e.g. Discharge Form DD-214, relevant agency application, etc . . .) to the agency or municipality administering the benefit for which the Veteran is applying. The administering agency or municipality shall then determine the Veteran’s eligibility for the benefit. A Veteran with a “Bad Conduct” or “Dishonorable” discharge is NOT eligible for Veteran’s benefits under this Public Act FAILURE TO PROVIDE THE DOCUMENTATION IN A TIMELY MANNER AS REQUESTED MAY RESULT IN A DELAY IN PROCESSING YOUR REQUEST - ANY PENALTIES, LATE FEE'S OR OTHER SUCH ISSUES DUE TO FAILURE TO PROVIDE SUCH DOCUMENTS WILL BE THE SOLE RESPONSIBILITY OF THE PERSON REQUESTING THE WAIVER. DD-214 Submission*Please check the appropriate boxI will be sending in a copy of my original Member-4, Service-2 or Service-7 copy of my DD-214 to your office via USP to the address shown above.I will have my original DD-214 (member-4, service-2 or service-7) verified by a Veterans Point of Contact at a Regional UConn Campus or at the Office of Veteran Affairs and Military Programs in StorrsGroup 1*Any document from this group must have been issued at least 1 (one) day prior to the date on your UConn Acceptance letter.Providing from Group 2Copy of a mortgage statement in your name for a CT addressCopy of your current valid CT driver's licenseCopy of a current, valid CT vehicle registration in your nameGroup 2*For Group 2 (two) you must provide 2 (two) documents. All documents from this group must have been issued at least 1 (one) day prior to the date on your UConn Acceptance letter Tax returns in your name with a CT address CT Voters registration card in your name Current cell phone or utility bill in your name for service at a CT address PLEASE REMEMBER THAT SUBMISSION AND APPROVAL OF THE VETERANS TUITION WAIVER WILL NOT RESULT IN THE WAIVER BEING AUTOMATICALLY APPLIED TO YOUR FEE BILL. YOU STILL MUST FILL OUT A FORM D FOR EACH TERM YOU WISH TO USE THE WAIVER, WWW.VETERANS.UCONN.EDU/FORMSFile upload - must be in jpg, gif, png, pdf formatsUpload any supporting documentation Drop files here or Select files Accepted file types: jpg, gif, ong, pdf, Max. file size: 100 MB, Max. files: 9. Name*By entering your name, you hereby declare under penalty of law, that you have read, understand, and accept the information, rules, regulations, conditions and instructions provided above. You understand that your failure to abide by the statements on this page may lead to your disqualification or denial of your waiver. First Middle Last PhoneThis field is for validation purposes and should be left unchanged.