Looking for a Va Form 22-1999 Templates? Download it for free!

Va Form 22-1999 - Instructions And Certifications For Va Enrollment Certification (Va Form 22-1999) Page 4

OMB Control No. 2900-0073

NOTE: Tear off the Instructions and Certifications sheet before completing the form.

Respondent Burden: 10 minutes

Side

VA ENROLLMENT CERTIFICATION

IMPORTANT: Side B is for flight, correspondence, and apprenticeship or on-the-job training programs.

(For chapter 35, include suffix. For transferability

(First, Middle, Last)

2. VA FILE NO.

1. NAME OF STUDENT

cases, enter the veteran's social security number)

(If not entered in

3. CURRENT ADDRESS OF STUDENT

4. SOCIAL SECURITY NUMBER OF STUDENT

Item 2)

5. NAME OF PROGRAM

6. TYPE OF TRAINING

(Not Flight

7. CREDIT FOR PREVIOUS TRAINING

)

FLIGHT TRAINING

CORRESPONDENCE

APPRENTICESHIP OR OTHER ON-THE-JOB

VOCATIONAL FLIGHT TRAINING (See Instructions)

8A. CREDIT ALLOWED FOR PREVIOUS EDUCATION AND TRAINING

8B. DATE TRAINING BEGAN

IN CURRENT COURSE

DUAL

SOLO

GROUND SCHOOL

CERTIFICATES AND RATINGS

8C. NUMBER OF HOURS/UNITS OF INSTRUCTION IN CURRENT COURSE

8D. TOTAL CHARGES

PRE- AND POST

DUAL

SOLO

GROUND SCHOOL

OTHER

FLIGHT

CORRESPONDENCE TRAINING

IMPORTANT: A VA Form 22-1999c, Certificate of Affirmation of Enrollment Agreement, MUST be signed by this student

and accompany this certification form before VA can authorize payment for this correspondence course.

9A. DATE FIRST LESSON

9B. NUMBER OF LESSONS FOR

9C. CHARGE PER LESSON TO

9D. WERE ANY LESSONS SERVICED BEFORE THE

SENT TO STUDENT

WHICH STUDENT IS ENROLLED

STUDENT

DATE ENTERED IN ITEM 9A?

(If "Yes," show lesson number and

YES

date serviced in Item 11, "Remarks")

APPRENTICESHIP AND OTHER ON-THE-JOB TRAINING

IMPORTANT: A signed copy of the training agreement outlining the training program and wage scale as approved by the State

Approving agency or VA, or for apprentices, any document signed by the trainee incorporating this agreement by reference must be

attached to this form. (Show monthly number of hours worked to date in Item 11, "Remarks.")

10B. TYPE OF TRAINING

10A. TRAINING DATES

10C. NUMBER OF HOURS

10D. NUMBER OF HOURS IN

(Month, Day, Year)

TRAINEE IS EMPLOYED PER WEEK

STANDARD WORK WEEK

IN TRAINING PROGRAM

BEGINNING

ENDING

APPRENTICESHIP

HRS.

OTHER-ON-THE-JOB

HRS.

11. REMARKS

CERTIFICATIONS - The provisions described in paragraphs (1) through (14) on the attached sheet are certified.

12A. FACILITY CODE

12B. SCHOOL NAME AND ADDRESS

12C. TELEPHONE NUMBER OF CERTIFYING OFFICIAL

12D. SIGNATURE OF CERTIFYING OFFICIAL

12E. DATE SIGNED

VA FORM

22-1999

SUPERSEDES VA FORM 22-1999, DEC 2007,

MAR 2009

WHICH WILL NOT BE USED.

Va Form 22-1999 - Instructions And Certifications For Va Enrollment Certification (Va Form 22-1999) Page 4

Related Articles

Related forms

Related Categories