CHAMPVA Letter Request Form

This is request for a letter to be sent to CHAMPVA, or Tricare, regarding your enrollment status to continue receiving benefits through your parent.

Full name * Required
Boise State email address * Required

Your Boise State email address is your username@u.boisestate.edu
Boise State Student ID# * Required

Please be sure to provide the correct Boise State student number so we can look up your information.
Which GI Bill® benefit are you using? * Required
Please let me know what benefit you may qualify for. If you do not qualify for any GI Bill® benefit you will need to call our office and supply the SSN of your sponsor. 208/426-3744.
Which Term are you requesting this letter to cover? * Required

Identify the term i.e. Fall 2018. Please be aware, if you are not a fulltime student because you are waitlisted on a class, the letter CANNOT reflect you are a fulltime student.
What is your anticipated graduation date from Boise State University? * Required
I request the letter to be sent: * Required
- Directly to me so I can send to Tricare myself
- Directly to CHAMPVA
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