Section A: authority
EISP was established by Title VIII of Public Law 105-368 and codified at sections 7671-7675 of Title 38, United States Code. NNEI and VANEEP are specific initiatives derived from this authority.
10-0003K-2
Employee Incentive Scholarship Program (EISP) Agreement
- Agency
- VA
- Revision
- September 2019
- Fillable fields
- 14
- Pages
- 2
- Official source
- VA form page
- Checked
- October 20, 2026
VA Form 10-0003K-2: Employee Incentive Scholarship Program (EISP) Agreement
VA Form 10-0003K-2 is the Department of Veterans Affairs Employee Incentive Scholarship Program (EISP) Agreement. It is the agreement a Veterans Health Administration (VHA) employee signs to take part in EISP. The form lists two initiatives covered under EISP, the National Nursing Education Initiative (NNEI) and the VA National Education for Employees Program (VANEEP), and a checkbox at the top marks which program the agreement supports. It is a VA employee form, not a Veterans benefit application.
The form is two pages of terms in Sections A to G: the program's authority, the obligations of the Under Secretary for Health, the obligations of the employee, breach of the award, cancellation and waiver, consent to release information and general provisions. Page 2 ends with the period of obligated service, the service obligation occupation and the signatures of the applicant and of the Under Secretary for Health or an authorized representative. VA Form 10-0003k is the application that goes with it.
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What's in VA Form 10-0003K-2
Section B: VA's obligations
Subject to available funds, the Under Secretary for Health agrees to provide an award of tuition and reasonable educational expenses, confirm the employee's eligibility, and appoint the employee to a position providing health services after the training.
Section C: employee's obligations
Eleven items, among them keeping enrollment, academic standing, work performance and VA employment, notifying the Program Coordinator of changes within 10 days, completing coursework within the time limits and serving a period of obligated service in VHA.
Section D: breach of the award
What the agreement says happens if a participant fails to accept payment, fails to keep academic standing or employment, or does not complete obligated service: $1,500 as liquidated damages, repayment of all funds paid, or triple damages under a printed formula.
Sections E to G: waiver, consent and general
Cancellation of obligations on the death of the participant, waiver or suspension by the Under Secretary for Health, consent for the school to release information, and the general provisions the applicant agrees to.
Signature block
The period of obligated service in years, months and days, the service obligation occupation, the applicant's printed name, signature and date, and the Under Secretary's signature and date. Page 1 has a footer line for applicant name, station number and initial.
How to complete VA Form 10-0003K-2
- 1
Check the program
Mark EISP, NNEI or VANEEP at the top to show which scholarship program the agreement is executed in support of.
- 2
Read Sections A to G
Above the signature lines the agreement reads: I have read and understand the above agreement.
- 3
Fill in the obligated service
Enter the period of obligated service in years, months and days, and the service obligation occupation.
- 4
Sign and initial
Print or type the applicant name, sign and date page 2, and add the name, station number and initial in the footer of page 1.
- 5
Acceptance by VA
The Under Secretary for Health or an authorized representative signs to accept the agreement, and the Program Coordinator returns a completed copy to the participant.
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Acceptance and copies
When it takes effect
Section G says the Under Secretary for Health or authorized representative must accept this agreement before it becomes effective.
Your copy
The form says the Program Coordinator will ensure a completed copy is returned to the participant for retention in their personal records.
Reporting changes
Section C asks the employee to notify the Program Coordinator in writing within 10 days of a change in name, address, telephone number, plan of study, academic standing, academic enrollment status, employment status or facility transfer.
Edition
The PDF footer reads VA FORM SEP 2019 10-0003K-2, matching the September 2019 revision date on VA's page.
Related forms
Who signs VA Form 10-0003K-2?
The agreement names the parties to it and who keeps each copy.
Official sources and the blank
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Questions about Form 10-0003K-2
What is VA Form 10-0003K-2?
It is the Employee Incentive Scholarship Program (EISP) Agreement between a VHA employee and the Under Secretary for Health. VA Form 10-0003k is the application that goes with it.
Which programs does the agreement cover?
The form lists EISP and two initiatives covered under it: the National Nursing Education Initiative (NNEI) and the VA National Education for Employees Program (VANEEP).
How long is the service obligation?
Section C says a full-time student incurs a service obligation of three years, and a part-time student's obligation is pro-rated, but in no event less than one year or greater than three years.
How long can the coursework take?
Section C says a maximum of three years after enrollment for full-time students and a maximum of six years after enrollment for part-time students.
What does the agreement say about breach?
Section D lists $1,500 as liquidated damages for failing to accept payment, repayment of all funds for failing academic standing or employment, and triple damages under a printed formula for not completing obligated service.
Can the obligation be cancelled or waived?
Section E says obligations are cancelled on the death of the participant, and the Under Secretary for Health may waive or suspend them when compliance is impossible due to circumstances beyond the participant's control, or in the best interest of VA.