Office of the Registrar

Veterans Benefits Registration Form

Veterans Services - Room 100 Hearnes Hall
Joplin MO 64801
417-625-3159/9389

The completion of this form authorizes Veteran Services to provide required information and to certify your enrollment at MSSU for a specified semester to the US Department of Veterans Affairs, St. Louis MO Under Chapters 30,32 or 35, Title 38, U.S.C. or Chapter 1606, 10 U.S.D.

You may complete this form online and email it to the Veterans office of Missouri Southern OR you may print this form and fax it to 417-659-4429 OR mail to:

Missouri Southern State College
Veterans Services - Room 100 Hearnes Hall
Joplin MO 64801
417-625-3159/9389

Fields requiring entry are in red.

(Students last name) (Student's first name)
SSN (required)
Preferred Name
Maiden Name
Email Address (required)
Permanent Address: (required)


City  
State  (required)   Zip Code  (required)
Home Phone (required)
Work Phone
Is this a change of address? Yes No
Please indicate your appropriate category
CH 30 New Montgomery GI bill - Prior or Active Duty
CH 31 Disabled Veterans/Vocational Rehabiliation
CH 35 Survivors/Dependents Education Assistance Program
CH 1606 New Montgomery GI Bill selected Reserve/National Guard - Will you use military tuition assistance? Yes  No
Branch of Service?
Have you applied for Financial Aid? Yes No
(You may apply for other forms of financial aid. Please contact Financial Aid)
Please indicate type of degree: Bachelor Associate Other
What is your major?
(Major must be declared by the end of your second semester)
Is this a change in Program? Yes No
I am applying as: (required)
First Time Freshman
Transfer
Post Graduate Student
Former MSSU Student
Dual Credit
Credit-In-Escrow
College term in which you expect to enroll: (required)
Fall 20
Spring 20
Summer 20
Have you received VA benefits at other schools? Yes No
Have you requested transcripts from the other schools to be sent to MSSU? Yes No
If you are enrolled in any classes at the time you are completing this form, please fill out your schedule below:

Semester:
Total Number of Hours:
Total Number of Remedial Hours:

You have completed Missouri Southern's online Veterans Benefits Registration Form. Be sure to read the following statements.

THANK YOU!

The following may affect the monthly dollar amount of G.I. Bill Educational benefit check: dropping or adding classes, enrolling in an unauthorized repeat of a class, enrolling in courses not authorized under the general education requirements or degree program.

I understand . . . .

  • I must attend class, make satisfactory progress and maintain a 2.0 grade point average and that it is my responsibility to notify Veterans Services if I make changes in my class load.
  • I will provide information to the Office of Financial Aid regarding my veteran status, category and monthly rate of pay.
  • I will request assistance from Veterans Services in order to comply with these regulations.
  • I will report any changes to my class schedule immediately to the Veterans Office.
I verify I have read the above statement.

I understand the above guidelines and acknowledge that I must complete a new Veterans Registration form each semester in order to receive my GI Bill check. (PLEASE ENTER EITHER YES OR NO) (required)

(Date submitted) (required)

Please submit this form by clicking on the SUBMIT button below OR print it and fax to Missouri Southern State College Veterans Office at 417.659.3117.

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