Virginia Department of Veterans Services/Virginia Military Student Laptop Application

To apply for enrollment in the Military Education Workforce Technology Project, please complete the following form. This initiative is brought to you by grant funds afforded by the Altria Group.

"*" indicates required fields

Name*

Address*

Address 2

City*

State*

Zip*

Phone*

Email*

I am a*

Veteran

Spouse of a Veteran

Branch of Service*

Pay Grade*

Military Occupational Specialty*

Date of Initial Entry into Military*

Final Date of Active Military Service*

Date of Marriage (spouse only)*

Type of Discharge*

I will be attending the below institution, taking the following course.*

Yes

Name of School*

**Verification will be required by School Veritas Representative

VCU Criteria

Laptops will be awarded on a first come, first serve basis.
Student must demonstrate need for the computer by submitting a written request (1 paragraph) to stross@vcu.edu
Student must be a veteran or current spouse of an active duty service member or veteran
Student must be currently enrolled

Program/Course*

Dates of Enrollment*

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Phone

This field is for validation purposes and should be left unchanged.

Education, Transition & Employment

Virginia Department of Veterans Services/Virginia Military Student Laptop Application