Military Priority Enrollment Request Form
UREG (Office of the University Registrar)
1001 N. Emmet Street ▪ PO Box 400203
Charlottesville, VA 22904-4203
Fax: 434-924-4156 ▪ Phone: 434-924-4122
Email: [email protected]
Office Use Only:
Date Received: ________________
Date Processed: ________________
Group:
________________
Date Student Notified: ____________
Signed (Initials): _______________
Veterans, active duty service members, and reservists are eligible for priority enrollment at the University of
Virginia.
Student Information
Student ID:
Name (Last, First, MI):
UVA Email:
__________________________
________________________________________________________________
School: Choose
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item.
Term Requested:
______________________
Military Service Information
Select your current military status: ☐Active Duty Military ☐Veteran ☐National Guard/Reservist
Deadlines for submission:
Fall and Summer: March 1st
Spring and January Term: October 1st
Please provide one of the following proofs of military status when submitting this form:
1. DD214 – Certificate of Release or Discharge from Active Duty
2. DD256 – Honorable Discharge Certificate
3. Military Orders
4. Military Identification Card
5. WD AGO – Enlistment Record
6. Veteran Identification Card (Virginia)
ROTC departments report eligibility for ROTC students.
Priority enrollment is not available for students in their first year as an undergraduate student.
I acknowledge that the information provided on this form is correct.
Signature : ______________________________
(Digital Signature Not Accepted)
Date: _______________________
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