VA Certification Request
VA Certification Request Form
Major/Program of Study
What degree are you working on?
What grade level are you?
Are you graduating?
VA Benefit Information
Are you the Veteran, Spouse, or Dependent?
Have you submitted your certificate of eligibility?
Have you applied for your benefits with the VA?
Which type of benefit will you be using?
Post 9/11 (Ch.33)
Vocational Rehab (Ch. 31)
DEA (Ch. 35)
Montgomery GI Bill - Active Duty (Ch. 30)
Montgomery GI Bill - Reserves (1606)
Have you met with your vocational rehab counselor for this term's eligibility?
Please provide the veteran's SSN below
Do you plan to use Military Tuition Assistance as well?
Financial Aid & Registration
Have you completed a FAFSA?
What semester is this request for?
Will your benefits expire during this term?
What type of registration request is this?
Initial Term Registration
Drop a Course
Add a Course
Please enter all of the courses you would like to be certified for:
Course Title(s) & Code(s)
Eg., College Algebra - MTH 1351
Are you repeating any of the courses listed above?
If you are ready to submit your COE or a screen shot of your Ebenefits, please do so below. If you would like to submit it at a later time, please email it to
Certificate of Eligibility
Term & Conditions
Please read and check each term and condition below.
While I am receiving VA Benefits, I agree to:
Notify the VA Certifying Official if I change my
degree, major or minor.
Notify the VA Certifying Official when I drop or add a
Notify the VA Certifying Official if I withdraw from
all my classes within a term.
I understand that:
After initial certification for the semester requested has been completed, any changes to my schedule will be processed after the census date.
I must Immediately inform Student Central of any changes to my schedule via the VA certification form as any changes made after Census dates affects money sent to the school. If I make any changes to my schedule after the enrollment certification is submitted, I may be liable for any money owed to the VA.