Fillable Form VA 22-1995 (2020)

What is VA Form 22-1995?

VA Form 22-1995 or Request for Change of Program or Place or Training is a form produced by the Department of Veterans Affairs (DVA). It serves veterans who are opting to change their current program or to transfer to another training location.

What is the purpose of VA Form 22-1995?

The purpose of VA Form 22-1995 is to help veterans who want to change schools or change their educational, professional, or vocational goals. Moreover, VA Form 22-1995 enables veterans who left their program to reenter, even if they left their program initially due to unsatisfactory attendance, progress, or conduct. VA Form 22-1995 also aids veterans who were receiving VA education benefits to receive their acquired benefits even while they are active in military duty. Lastly, VA Form 22-1995 helps veterans to use entirely their Post 9/11 Bill benefits or they may choose to use entirely all their existing benefits within the next one-hundred eighty (180) days and opt to apply for the Edith Nourse Rogers STEM Scholarship.

Who should file VA Form 22-1995?

Veterans who are planning to:

• Change schools,
• Change their educational, professional, or vocational goal,
• Reenter the same program they left before due to unsatisfactory attendance, progress, or conduct
• Receive their VA education benefits as a veteran and are opting to receive these benefits while being active in military duty,
• Exhaust their Post-9/11 Bill benefits or all their existing benefits and would like to apply for the Edith Nourse Rogers STEM Scholarship.

Where should I file and submit VA Form 22-1995?

As per the instructions in the actual form, where and how you should file your VA Form 22-1995 depends on your location and if you have selected a school or training establishment.

(A) If you have selected a school or training establishment.

Step 1:

Mail the completed form to the VA Regional Processing Office in the region of that school's or establishment's physical address. Determine the correct office from the list on page 4. For Edith Nourse Rogers STEM Scholarship recipients, you must mail your completed form to the Buffalo, NY office listed on page 4.

Step 2:

Notify the veterans certifying official at your school or training establishment that you have applied for VA education benefits. Ask him or her to submit your enrollment information using VA Form 22-1999, Enrollment Certification, or its electronic version.

Step 3:

Wait for VA to process your application and notify you of our decision concerning your continued eligibility for educational assistance.

(B) If you have not selected a school or training establishment.

Step 1:

Mail the completed form to the VA Regional Processing Office in the region of your home address. Determine the correct office from the list on page 4.

Step 2:

Wait for VA to process your application and notify you of our decision concerning your continued eligibility for educational assistance.

How to fill out VA Form 22-1995?

For ease of accomplishing VA Form 22-1995, have the following documents and information ready to you:

• Your Social Security Number (SSN)
• Background information regarding the school or training facility you want to transfer or be enrolled to
• If you are planning to add or change an account, have your bank account’s direct deposit information
• Your military history
• Your education history

VA Form 22-1995 consists of five (5) parts. Begin filling out VA Form 22-1995 by reading the box under the caption “Request to Opt-Out of Information Sharing With Educational Institutions.” If you mark the box, you certify that the DVA does not have your permission to share information about your veterans' education benefits with any educational institution and that you understand that sharing your information with your school is intended to support the certification process and that "opting-out" may delay that process.

For Part 1, write/type down accurately and honestly the information being asked.

1. A. NAME OF APPLICANT

Using the LAST, FIRST, MIDDLE name format, state your full name.

1. B. MAILING ADDRESS

State your complete street address. Include your City, State, and 9-digit ZIP Code.

1. C. APPLICANT'S TELEPHONE NUMBER

Report your day and evening telephone number with its corresponding area code.

1. D. VA FILE NUMBER
2. E. APPLICANT'S E-MAIL ADDRESS or N/A
3. F. SOCIAL SECURITY OF APPLICANT

For Part 2, mark the boxes that match accordingly to you and write/type down accurately and honestly the information being asked.

2. EDUCATION BENEFIT YOU WANT TO RECEIVE

Select only one box. If you are selecting the Edith Nourse Rogers STEM Scholarship, make sure you check box C “Edith Nourse Rogers STEM Scholarship” and mail to:

Buffalo VA Regional Office, P.O. Box 4616, Buffalo NY 14240-4616.

3. HOW WILL YOU TAKE TRAINING?

Select the box that applies to you.

4. A. WHAT EDUCATIONAL, PROFESSIONAL OR VOCATIONAL GOAL ARE YOU WORKING TOWARD?

Here are some examples of the "goals" being asked:

• Educational goal: GED certificate, high school diploma, bachelor's degree, master's degree, Ph.D
• Professional goal: lawyer, physician, teacher, physical therapist, medical technologist, medical records librarian, stenographer, machinist, electronic technician, X-ray technician, radio
• Vocational goal: TV service technician, automobile mechanic, practical nurse.

4. B. WHAT IS THE NAME OF THE PROGRAM YOU ARE REQUESTING?

4. C. IF CHANGING SCHOOLS, PROVIDE NAME AND COMPLETE ADDRESS OF NEW SCHOOL OR TRAINING ESTABLISHMENT YOU ARE PLANNING TO ATTEND

Only fill this out if applicable.

4. D. PROVIDE NAME AND COMPLETE ADDRESS OF PREVIOUS SCHOOL OR TRAINING ESTABLISHMENT

Only fill this out if you are changing schools. List down your current school.

4. E. TELL US WHEN AND WHY YOU STOPPED TRAINING AT YOUR PRIOR SCHOOL OR ESTABLISHMENT. CONTINUE IN REMARKS, ITEM 10, OR ON A SEPARATE SHEET IF NECESSARY.

Only fill this out if applicable.

Items 4F and 4G are to be filled out only by STEM Scholarship applicants only.

4. F. ARE YOU ENROLLED IN AN UNDERGRADUATE STEM DEGREE PROGRAM OR HAVE YOU GRADUATED FROM A STEM DEGREE PROGRAM AND PURSUING A TEACHING CERTIFICATION?

Select your answer between the ‘Yes’ and ‘No’ boxes.

4. G. ARE YOU CURRENTLY ON ACTIVE DUTY OR DO YOU ANTICIPATE YOU WILL BE GOING ON ACTIVE DUTY?

Select your answer between the ‘Yes’ and ‘No’ boxes.

For Part 3, mark the boxes that match accordingly to you and write/type down accurately and honestly the information being asked.

5. The Department of the Treasury requires all Federal benefit payments be made by electronic funds transfer (EFT), also called direct deposit (Direct Deposit is not available for Chapter 32 recipients). To enroll in direct deposit, please attach a voided personal check, deposit slip, or provide the information requested in Item 5.

5. A. TYPE OF ACCOUNT

Select your answer between the ‘Checking’ and ‘Saving’ boxes.

5. B. NAME OF FINANCIAL INSTITUTION

5. C. 9 DIGIT ROUTING OR TRANSIT NUMBER

5. D. ACCOUNT NUMBER

For Part 4, mark the boxes that match accordingly to you and write/type down accurately and honestly the information being asked.

6. INFORMATION ON DEPENDENTS

Complete this item only if you served BEFORE January 1, 1977 (or had a delayed entry before January 2, 1978) and you currently have dependents. Provide your dependents' information

6. A. ARE YOU CURRENTLY MARRIED?

IMPORTANT: If you are certifying that you are married for the purpose of VA benefits, your marriage must be recognized by the place where you and/or your spouse resided at the time of marriage, or where you and/or your spouse resided when you filed your claim (or a later date

when you become eligible for benefits) (38 U.S.C. § 103(c)).

6. B. DO YOU HAVE ANY CHILDREN WHO ARE :

• UNDER THE AGE OF 18? OR
• OVER 18 BUT UNDER AGE 23, NOT MARRIED AND ATTENDING SCHOOL? OR
• OF ANY AGE PERMANENTLY HELPLESS FOR MENTAL OR PHYSICAL REASONS?

Select your answers between the ‘Yes’ and ‘No’ boxes.

6. C. IS EITHER YOUR FATHER OR MOTHER DEPENDENT UPON YOU FOR FINANCIAL SUPPORT?

Select your answer between the ‘Yes’ and ‘No’ boxes.

7. RECENT PERIODS OF SERVICE (PERIODS OF ACTIVE DUTY SINCE YOUR INITIAL PERIOD OF ACTIVE DUTY.)

Please complete this section for each period of your active duty since your initial period of active duty if you have not previously reported this information. It will help VA process your claim if you attach a certified copy of "Member 4 Copy" of your DD Form 214 for each period of active service. (Don't report Active Duty for Training.)

7. A. BRANCH OF SERVICE AND RESERVE OR GUARD COMPONENT SERVED IN DURING ACTIVE DUTY

List down the branch/es of service and reserve or guard component served in during your active duty.

7. B. BEGINNING AND ENDING DATES OF ACTIVE DUTY

7. C. WERE YOU INVOLUNTARILY CALLED TO ACTIVE DUTY FOR THIS PERIOD? (If yes send in copies of your orders)

7. D. WHAT WAS THE CHARACTER OF YOUR DISCHARGE?

7. E. IF THIS ACTIVE DUTY IS NATIONAL GUARD DUTY, INDICATE IF AUTHORITY IS TITLE 10 (FEDERAL) OR TITLE 32 (STATE).

Attach copies of any orders.

8. DO YOU EXPECT TO RECEIVE EDUCATIONAL BENEFITS UNDER THE GOVERNMENT EMPLOYEE'S TRAINING ACT (GETA) FOR THE SAME COURSE(S) YOU WILL RECEIVE VA EDUCATION BENEFITS?

Answer only if you are a Federal Government employee. Select your answer between the ‘Yes’ and ‘No’ boxes.

9. ARE YOU RECEIVING OR DO YOU ANTICIPATE RECEIVING ANY MONEY (including but not limited to Federal Tuition Assistance) FROM THE ARMED FORCES OR PUBLIC HEALTH SERVICE FOR THE COURSE FOR WHICH YOU HAVE APPLIED TO VA FOR EDUCATION BENEFITS?

If you will receive such benefits, check ‘Yes.’ Show complete details in the remarks section to include the source of the funds. Check ‘No’ if you are applying for the tuition assistance top-up benefit. Answer only if you are on Active Duty.

10. Remarks

For Part 5, review the information you have reported in the form before affixing your signature to the form along with the date of signing. If you are currently on active duty, have your Education Service Officer sign and date items 11A and 11B.