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Learn what the PACT Act means for your VA benefits

About VA Form 22-5495

Form name: Dependents’ Request for Change of Program or Place of Training
Related to: Education and training, Family member benefits
Form last updated: May 2022

When to use this form

Use VA Form 22-5495 to request changes to your education benefits if you’re using one of these programs:

  • Survivors’ and Dependents’ Educational Assistance (DEA) program, or
  • Fry Scholarship

Downloadable PDF

Download VA Form 22-5495 (PDF)

Online tool

You can submit your request online instead of filling out and sending us the paper form.

Go to the online tool