Membership Application Central Virginia Community College

Fields marked with a red asterisk are required.

*First Name:

*Last Name:

*Email Address:

Phone Number:

Street Address:

City:

State:

Zip Code:

Have you applied for education benefits?:

Yes, I have appliedNo, have not applied

*Please list all branches of service and/or reservist branches and discharge dates.:

*Membership Status:

Active? currently a CVCC student
Alumni? formerly a CVCC student

*Interests:

Financial Aid/Scholarships
Social Events
Serve as an Elected Officer
Other

*Security code:

Enter security code:

Contact Tina Murphy:
Phone: 434.832.7631
Email: murphyt@centralvirginia.edu

Please call to schedule an appointment.

Hours of Operation:

Days	Hours
Mon. - Fri.	8:00 AM - 5:00 PM
Sat. - Sun.	CLOSED

Regional Processing Center
Buffalo, NY
888.442.4551

Department of Veterans Affairs
800.827.1000
www.gibill.va.gov

SVO Membership Application