Benefits Request Form

Personal Information
Application Information


Please indicate your secondary major/goal. The VA will only allow double majors when those majors are interrelated to a specific occupational career. Double majors/goals must be noted on your Educational Plan to be certified.


Note: All students using benefits taking major required courses must have an updated Ed Plan on file to be certified.


Note: All students using benefits must start a physical file in the Veterans Service Office in order to be certified. Please visit the VSO at LAC campus in "E"08 ( lower level of the "E" bldg. ) as soon as possible to process your benefits.


Due to the time delay of VA payments, we recommend that all students pay their Student Health Fee within 3 days of enrollment. If a payment is not received in a timely fashion, LBCC has the right to drop students' courses


I certify that all information is complete and correct. I agree to inform The Veterans Service Office of any changes in my enrollment status (adding/dropping certified class). I understand that failure to do so may result in me owing a debt to the Veterans Administration

* - Denotes required fields