Certification Request Form - Spring 2023
The Certification Request Form must be submitted each semester by students who are using VA and military tuition assistance at the University of Central Missouri. 
Email *
Last Name *
First Name *
700 # *
If you do not have a 700#, please type n/a.
Street *
City *
State *
Zip Code *
Phone Number *
Student Status *
Military branch *
Semester requesting to use benefits: *
I request to have my enrollment certified to the VA for the following benefit: *
Military Tuition Assistance (For Active Duty/Reserve/Guard) *
Upon receiving your Military Tuition Assistance, the Active Military Tuition Rate of $250 per credit hour for undergraduate courses will automatically be applied to your student account.
Please read and acknowledge below: *
Required
I understand and acknowledge the above information and agree to comply with VA regulations. *
Required
A copy of your responses will be emailed to the address you provided.
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