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My
LaurelRidge
VA Certification Request
Form
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Home
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Military and Veteran
Services
»
VA Certification Request
Form
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*
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Email
This field is for validation purposes and should be left unchanged.
Your Information
Name
*
First
Last
Email
*
Enter Email
Confirm Email
Laurel Ridge Student ID Number
*
Benefits
Are you a new student at Laurel Ridge?
*
Yes
No
Is this your first semester using Military benefits at Laurel Ridge?
*
Yes
No
Are you a Guest Student (taking courses at another college) at Laurel Ridge?
*
Yes
No
As you are a guest student, please indicate the name of your parent school:
*
Semester you are requesting certification for:
*
Spring
Summer
Fall
Please select your Benefits Chapter(s):
*
You may select more than one.
Chapter 30 (MGIB)
Chapter 31 VR&E
Chapter 33 (Post 9/11)
Chapter 35 (Dependents)
Chapter 1606 (Reservist)
Tuition Assistance - Federal
Tuition Reimbursement - VANG
VMSDEP
Do you want your VA benefits to cover all of your classes this semester?
*
Yes
No
Unsure
Program of Study
Program Name
*
If unsure, please view the programs offered at Laurel Ridge at
laurelridge.edu/pathways
.
Tuition Payments
How do you plan to pay your tuition? Please select all that apply:
Cash, Check, Credit
Anticipated Financial Aid
Chapter 31 VR&E
Chapter 33 (Post 9/11)
VMSDEP Benefits
Tuition Assistance
Required Statements
By marking each statement below, you certify that you have read and agree to the following:
Courses and Progress
*
I understand that I can only receive benefits for courses required for my degree or certificate program and I must make satisfactory progress toward graduation/completion.
I agree
Student Responsibilities
*
• I understand the VA determines benefit eligibility and payments.
• I understand it is my responsibility to know what benefits I have.
• I understand I must notify the military benefits official of any enrollment changes I make.
• I understand any enrollment changes I make may result in a debt to Laurel Ridge and/or VA.
I agree
Form Requirements
*
I understand this form is required every semester I want to use military education benefits. My courses will not be certified with the VA if this form is not completed.
I agree
Full-Time Status
*
I understand that full time status is different for summer enrollment.
I agree
Form Questions
*
If I have any questions about the information on this form or about my military benefits, I will speak to the military benefits official or call the VA Education Hotline: 1-888-442-4551.
I agree
Post 9/11 (Chapter 33) Recipients - BAH
*
• My housing allowance (BAH) rate is determined by my rate of pursuit and what location I take equal or majority of my in-person courses. The US Department of Veteran Affairs calculates all BAH (housing stipends) amounts. For more information 1-888-442-4551
• I must verify my attendance with the VA. If I fail to verify my enrollment for two consecutive months, my BAH will not be paid to me.
• For more information,
GI Bill enrollment verification information
.
I agree
Post 9/11 (Chapter 33) Recipients - Financials
*
• I understand, tuition and fees will be paid by VA directly to Laurel Ridge approximately 3 weeks after the drop period.
• To avoid delayed disbursement of my financial aid, I must provide my certificate of eligibility prior to the first day of the term of enrollment. Otherwise, my financial aid will be applied to my student balance.
I agree
Post 9/11 (Chapter 33) Recipients - Enrollment
*
• Once initial enrollment is submitted to the VA, I can make enrollment changes. However, I understand any changes cannot be reported to the VA until after the drop period ends.
I agree
Please include any comments or questions regarding this form:
Please enter your full name below. In doing so you agree to the guidelines and statements submitted via this form:
*
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