Otagnc Form 621 100 PDF Details

The North Carolina National Guard Application for Tuition Assistance, known as the OTAGNC 621-100 form, is a crucial document for members of the state's National Guard seeking financial support for their educational pursuits. This comprehensive form not only gathers applicant's personal and contact information but also mandates details regarding their educational institution, course data, and a clear understanding of the program's rules and prerequisites. Applicants must acknowledge that tuition assistance is contingent upon the availability of funds and is distributed on a first-come, first-served basis. Critical deadlines are also highlighted, with the stipulation that forms must be submitted no later than 20 days before the start of classes to be considered eligible. Additionally, the form underscores expectations of good standing within the unit and a minimum service obligation post-education. The document elucidates the support's scope, covering tuition and required fees while specifying that textbook and material costs fall under the applicant's responsibility, albeit with potential for coverage if funds permit. Importantly, the form includes certification sections that demand the applicant's acknowledgment of their duties regarding the application process, their understanding of the program's conditions, and the potential financial repercussions of failing to meet the program's standards or service obligations. Overall, the OTAGNC 621-100 form serves as both a contract and guide for National Guard members navigating the process of securing tuition assistance for their educational advancement.

QuestionAnswer
Form NameOtagnc Form 621 100
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesNCTAP Application nctap form

Form Preview Example

NORTH CAROLINA NATIONAL GUARD

APPLICATION FOR TUITION ASSISTANCE - NC TAP

SECTION I - APPLICANT DATA

A. APPLICANT NAME (Last, First, MI)

B. MAIDEN NAME

C. SSN

D. RANK / GRADE

E. APPLICANT ADDRESS

F. CITY

G. STATE

H. ZIP

I. AKO EMAIL ADDRESS (REQUIRED)

J. OTHER EMAIL ADDRESS

(1)I understand tuition assistance is awarded based on the availability of funds and is awarded on a first-come, first-served basis.

(2)I acknowledge this form must be submitted 20 days PRIOR to the start date of classes and that failure to comply could result in denial of tuition benefits.

By Signing Below SM acknowledges that he/she understands (1) and (2) above and has read and initialed the certification on the back of this form.

K. APPLICANT SIGNATURE

L. PHONE

M. DATE Year Month Day

SECTION II - UNIT INFORMATION

 

 

 

 

A. IS SM IN GOOD STANDING WITH UNIT?

 

B. ETS Year Month Day SM MUST MEET MINIMUM SERVICE OBLIGATION OF 2 YRS REMAINING IN THE NCNG

 

YES or NO (circle one)

 

 

AT THE END OF THE ACADEMIC PERIOD FOR WHICH THIS AWARD WILL BE APPLIED.

 

 

 

 

 

C. UNIT OF ASSIGNMENT / UIC

 

 

 

D.

 

GUARD: ARMY or AIR / AGR: YES or NO

 

 

 

 

 

 

 

 

 

(circle one)

 

(circle one)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

E. AUTHORIZED SIGNATURE OF CDR OR UNIT REP

 

 

F. PRINT NAME

 

 

G. TITLE

 

H. DATE Year Month Day

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION III - EDUCATIONAL INSTITUTION - COURSE DATA

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A. NAME OF EDUCATIONAL INSTITUTION

B. ADDRESS OF EDUCATIONAL INSTITUTION

 

C. ARE YOUR CLASSES ONLINE?

 

 

 

 

 

 

 

 

 

 

 

YES or NO

If yes, please write” ONL” next

 

 

 

 

 

 

 

 

 

 

 

(circle one)

to the class in the title section

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D. COURSE #

E. TITLE

 

F. # CREDITS

G. COURSE #

 

H. TITLE

 

 

I. # CREDITS

 

1.

 

 

 

 

4.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

 

 

 

 

5.

 

 

 

 

 

 

 

 

3.

 

 

 

 

 

6.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

J. ACTUAL COST OF

 

 

 

 

 

 

 

 

 

 

 

 

 

TUITION FOR COURSES

 

 

K. DEGREE PROGRAM

L. SEMESTER STARTS

 

M. SEMESTER ENDS

 

 

N. SEMESTER TERM

 

LISTED:

$

 

 

 

 

 

 

 

 

 

 

 

 

ACTUAL COST OF

 

 

 

 

 

 

 

 

 

 

 

 

 

REQUIRED

 

 

Undergraduate or Graduate

 

 

 

 

 

 

 

 

FEES FOR COURSES

$

 

(circle one)

 

 

 

 

 

 

 

 

LISTED:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL TUITION & FEES

 

 

O. Course of Study

 

 

 

 

 

 

 

 

FOR COURSES LISTED:

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

P. AUTHORIZED SIGNATURE OF SCHOOL OFFICIAL

 

 

Q. PRINT NAME

 

 

 

R. TITLE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

S. EMAIL ADDRESS

 

 

 

 

T. PHONE

 

 

 

U. DATE Year Month Day

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION IV - NCNG EDUCATION SERVICES OFFICE USE ONLY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A. TUITION AMOUNT TO BE AWARDED:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B. DENIED FOR THE FOLLOWING REASONS:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Educational institution is NOT a State approved school

 

 

Applicant is not in good standing with unit. SM must contact unit

 

 

 

 

 

 

 

 

 

 

 

 

 

ETS does NOT meet 2 year minimum requirement

 

 

 

 

Application received after deadline due date

 

 

 

 

 

SM has reached NC TAP maximum amount for this Fiscal Year

 

 

Applicant is receiving FTA in the amount of: $

 

 

 

 

 

SM Needs to apply for Federal Tuition Assistance (FTA)

 

 

Add'l funds - YES or NO. If yes, award amount: $

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SEE REVERSE OR SECOND PAGE

OTAGNC FORM 621-100, MAY 2009 INTERIM FORM (PREVIOUS EDITIONS ARE OBSOLETE)

GENERAL:

Under the North Carolina National Guard Tuition Assistance Program (NC TAP), members may be awarded monetary assistance for tuition and required fees. Required textbooks and materials are the student's responsibility and may be awarded by the program if funding is available after tuition and required fees has been paid for each approved application. The determination to award a monetary benefit for textbooks and materials will be made at the end of the program's fiscal year.

NC TAP benefits can be used at any approved educational institution in North Carolina. Please visit

http://www.northcarolina.edu/content.php/apps/ncsaa/index.php for a list of approved North Carolina Schools.

Maximum award per academic year (1 July to 30 June) is based on the highest tuition and fees at The University of North Carolina at Chapel Hill which may be used in one academic period or as the applicant desires. Award may be decreased, at the program manager's discretion, due to budget constraints. Awards are made on a first-come, first-served basis until funds are depleted.

NC TAP is a reimbursement program and payments may be delayed after an award is issued. Applicants should NOT depend on monetary funds awarded through NC TAP for living, transportation, meals and other related expenses. All efforts will be made to expedite an award letter to the school once an applicant has been approved to receive tuition benefits.

Required fees are those fees which are universally applied to ALL students attending the education institution. Fees cannot be applied towards room and board, meals, health insurance and other optional fees.

If NC TAP is combined with any other military tuition assistance program then the combined programs cannot exceed the cost of tuition and required fees. Any and all excess funds after the aforementioned costs MUST be returned to the Education Services Office.

Based on approval of the application for tuition assistance by JFHQ-NC-J1-RRC-ESO, an award letter is issued to the educational institution and serves as authority to invoice the Department of Crime Control and Public Safety c/o NC Army National Guard Education Services Office for the amount specified in the award letter.

INSTRUCTIONS:

Section I - to be completed by applicant.

Section II - to be completed by unit/applicant. MUST be signed by unit Commander or Representative. Section III - to be completed by educational institution/applicant - MUST be signed by School Official. Section IV - for NCNG-ESO use only.

Applicant is responsible for ensuring that all sections of the application are completed before submitting it to the JFHQ-NC-J1-RRC-ESO.

Applications MUST be received by the Education Services Office 20 DAYS PRIOR TO THE START DATE OF CLASS.

Proof on enrollment must be sent to the Education Office no later than the last day of late registration.

Completed applications and proof of enrollment can be sent via:

(1)Email: NCESO@ng.army.mil with subject line: NC TAP

(2)Fax: 919.664.6520

(3)Mail: NC National Guard, attn: ESO - NC TAP Manager, 4105 Reedy Creek Road, Raleigh, NC 27607-6410

All correspondence regarding NC TAP applications will be sent by email; failure to provide a valid email address may result in delays or denials.

APPLICANT'S CERTIFICATION (initial each item):

_____I acknowledge and understand it is MY responsibility to ensure the application arrives at the Education Services Office by the deadline date.

_____I certify that the information provided herein is correct to the best of my knowledge. I have read the provisions of JFHQ-NC Regulation 621-1 and

understand that an award under the NC National Guard Tuition Assistance Program is dependent upon the availability of funds and a determination by the Adjutant General that the proposed academic program is in conformity with the intent of the NCNG Tuition Assistance Act and that all eligibility requirements have been met.

_____I also understand and accept the conditions that "satisfactory participation" includes attendance during scheduled IDT/AT periods with my unit, as

well as my conforming to appearance standards established by regulations.

_____I understand that being deemed as an "unsatisfactory participant" may result in my having to REFUND all or part of the tuition benefit previously

awarded to me. Additionally, no further awards will be made on my behalf until the determination has been reversed. Other situations which may result in my repaying all or part of monetary assistance includes: 1) failure to satisfactorily complete course(s) for which assistance is applied,

2) voluntary withdrawal from courses for which assistance is applied, and 3) failure to meet service obligation with the NC National Guard.

_____If my academic status changes, I will notify JFHQ-NC-J1-RRC-ESO and my NCNG Commander immediately. I authorize the educational

institution to forward all of my grade reports to the JFHQ-NC-J1-ESO.

SEE SECTION 1 ON REVERSE SIDE FOR REQUIRED SIGNATURE

OTAGNC FORM 621-100, MAY 2009 INTERIM FORM (PREVIOUS EDITIONS ARE OBSOLETE)

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