Certification Request Form

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Certification Request Form

Request Certification for VA Benefits

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Today's Date *

MM

/

DD

/

YYYY

Email *

Phone Number *

Last Name *

First Name *

Net ID *

Intended Major *

Term *

Summer 2023

Required

VA Benefit? *

Montgomery G.I. Bill (Ch. 30)

Veteran's Rehabilitation & Employment (Ch. 31)

Post 9/11 G.I. Bill (Ch. 33)

Transfer of Education Benefits (Ch. 33 TEB)

John David Fry Scholarship (Ch. 33 DF)

Dependent's Education Assistance (Ch. 35)

Montgomery G.I. Bill - Selected Reserve (Ch. 1606)

Active Duty or Guard/Reserve Tuition Assistance

Are you graduating this semester? *

Yes

No

PLEASE READ AND SELECT A RESPONSE FOR EACH STATEMENT BELOW.

I am requesting MSVC certify my enrollment with the VA for the term(s) selected above. *

I understand.

I do not understand. Please contact me.

It is my responsibility to inform the MVSC of any changes to my enrollment. * *

I understand.

I do not understand. Please contact me.

I understand that the VA will only cover in-state tuition costs. * *

I understand.

I do not understand. Please contact me.

I understand that withdrawals will result in student debt with the VA & the University *

I understand.

I do not understand. Please contact me.

I understand the VA will only pay for remedial or developmental classes(below the 100 course level) that are taken in residence. *

I understand.

I do not understand. Please contact me.

For Post 9/11: I understand that I must be a full time student in order to receive the full housing stipend. *

N/A I am not using the Post 9/11 G.I. Bill.

I understand.

I do not understand. Please contact me.

For Post 9/11: I understand that I must take at least one in residence/hybrid class each semester to receive my full housing allowance stipend. *

N/A I am not using the Post 9/11 G.I. Bill.

I understand.

I do not understand. Please contact me.

I understand that if I am using chapter 30 or chapter 1606 that I am required to verify my attendance with VA on the last day of every month by calling 877.823.2378 or at www.gibill.va.gov/wave/. *

N/A I am not using the Ch. 30, Montgomery G.I. Bill.

I understand.

I do not understand. Please contact me.

I understand that Ch. 33, Post 9/11 recipients, must verify attendance on the last day of each month beginning the Spring 2022 term by calling the VA at via text or email. * *

N/A I am not using the Post 9/11 G.I. Bill.

I understand.

I do not understand. Please contact me.

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