Veteran's Affairs Notice of Change of Schedule

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	Veterans Affairs Office Midwestern State University 3410 Taft Boulevard, Wichita Falls, TX 76308 GI Bill® is a registered trademark of the U.S. Department of Veterans Affairs (VA). More information about education benefits offered by VA is available at the official U.S. government website at http://www.benefits.va.gov/gibill.

Name:*

Last
First

2.	Mustangs ID #:* Please enter your Mustangs ID or M Number without the 'M'.

3.	Term:*

Chapter:*

	30 (Montgomery GI Bill)
	31 (VR&E)
	33 (Post-9/11 GI Bill)
	35 (DEA)
	1606 (MGIB – Selected Reserve)
	Hazlewood Act Exemption

Address:

Street 1
Street 2
City
State
ZIP

6.	Cell Phone #:* Please enter your 10 digit cell phone number. Example: 940-397-4000 would be 9403974000.

7.	Email:*

Change being made:*

	I am withdrawing from all classes for this term only
	I am not withdrawing from the semester, but making the following changes in my schedule

Schedule Change:*

	Adding
	Dropping

10.	I am adding:*

11.	I am dropping:*

12.	Reason for dropping class(es) or for withdrawing from the term:*

13.	Do you consider yourself to have “mitigating circumstances” for the drop or withdrawal? Mitigating circumstances can include, but are not limited to: Unavoidable changes in employment Unanticipated difficulties with child care arrangements Serious injury or illness afflicting the student Serious illness or death in the student’s immediate family Unanticipated active duty military service If so, explain why you feel you have mitigating circumstances for this drop or withdrawal (particularly long explanations should be submitted as a letter or email):

14.	Signature*
	Draw Signature with Cursor or Fingertip Clear

*

I understand that checking this box constitutes a legal signature confirming that the information I have provided is true and correct to the best of my knowledge.

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