ADJUTANT GENERAL - STATE TUITION ASSISTANCE REQUEST (SFN 61646)

STATE TUITION ASSISTANCE REQUEST
NORTH DAKOTA OFFICE OF ADJUTANT GENERAL
SFN 61646 (12-2023)
GENERAL INFORMATION
You must apply every semester.
- Applications must be received no later than 8 business days before class start date.
- Contact the State Tuition Manager (701-333-3008) if you are submitting a late application.
If you are a member of the ND Army National Guard, you must submit a Federal Tuition Assistance (FTA) Application using the ArmyIgnitED portal prior to submitting your State Tuition Assistance (STA) application. Please attach FTA form, DA Form 7792 in the supporting documentation block on page 2 as verification of requesting FTA. If you have exhausted your FTA benefit for the fiscal year, please annotate in the comment section.

Upon submission of the application, you will receive an automatic email confirmation that your application has been submitted. Your application is not automatically approved. If you are flagged for any reason, you will be denied for both FTA and STA.

NOTE: Use Comments box (at the end of the form) if you have a class start date after the semester begins.
First Name*
Last Name*
Telephone Number*
Please enter a valid phone number.
Email Address*
This is where the confirmation email will be sent.
Mailing Address*
City*
State*
ZIP Code*
Branch of Service*
Rank*
ETS (Expiration - Term of Service) Date *

MonthDayYear
Date
Enlistment Date in ND National Guard (NDNG)*

MonthDayYear
Date
Are you currently flagged for failed physical training, weight, or other adverse action? If so, you are not eligible for tuition reimbursement until the flag has been resolved.*

NoYes

SCHOOL INFORMATION
Student Identification (ID) Number*
Current Education Level*
Semester Attending*
Term/Session Start Date*

MonthDayYear
Date
Term/Session End Date*

MonthDayYear
Date
Primary College Attending (only colleges listed participate in the State Tuition Assistance Program)*
Name of Out-of-State College (primary)
Are you attending more than one college*

YesNo
Secondary/Additional College Attending
Name of Out-of-State College (secondary)
Attach Additional Documents

Accepted file types include: pdf, jpg, jpeg Maximum of 5 files Each file must not exceed 5MB in size
Cancelof

AUTHORIZATION PAGE
Comments

0/150
Application deadline is 8 business days before class start date. If you are applying late for a specific reason, contact the ND National Guard (NDNG) Education Office at 1-701-333-3008.

If you have difficulties with this form, please email the NDNG Education Office: ng.nd.ndarng.list.tuition-assistance@mail.mil or call (701) 333-3008.

By clicking the "Submit" button below, I am authorizing the ND National Guard, Education Office access to my academic records for the purpose of determining eligibility and the amount of tuition benefit I am to receive from the NDNG Tuition Assistance Program.
I agree to the terms and conditions
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