Va Enrollment Certification Request Form - University Of The Incarnate Word
Download a blank fillable Va Enrollment Certification Request Form - University Of The Incarnate Word in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Va Enrollment Certification Request Form - University Of The Incarnate Word with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1***SUBMIT EACH TERM/ SEMESTER OR CHANGE IN
ENROLLMENTS***
University of the Incarnate Word
VA Enrollment Certification Request
Name: _______________________________________________ Student ID: ________________________
Address: ________________________________________________________________
City, State __________________________________ Zip ______________ Address
Name Change [ ]
or
Phone: __________________ E-Mail: (UIW) _________ _______________ (personal) ________________________
Degree/Major: ________________________ Minor(s): __________________ Advisor: _______________________
UIW Academic Program: Main Campus[ ] ADCaP[ ] UIW Online[ ]
VA Chapter: 30- MGIB
31- Voc Rehab
35- Dependent
1606- Reserves
1607- REAP
33- Post 9/11
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
Post 9/11 GI Bill students: Veteran
Spouse
Dependent
[ ]
[ ]
[ ]
Student Status: new to UIW [ ] previous student [ ], last semester at UIW ____________ transfer
[ ]
List ALL Colleges Attended: _______________, ________________________, _____________________
Has Admissions/ the Registrar’s Office received ALL transcripts? Yes [ ] No [ ]
Previously used VA Educational Benefits: No [ ] Yes, at: [ ] UIW [ ] Other College: ___________________
any
Are you now on active duty? Yes [ ] No [ ] Using
Tuition Assistance (reserve/active)? Yes [ ] No [ ]
ROTC: Yes [ ] No [ ] If yes, contract cadet? Yes [ ] No [ ] Graduating this semester? Yes [ ] No [ ]
Semester/Year:
Fall ______
Spring ______
Summer ______
Term Dates
List All Courses: Subject/Number
Credit
Required for Degree/Minor
Ex: ENGL 1311, ORGD 6320)
(
Hrs.
(Y/N)
Total Hours for VA Certification: _____ if repeating a course, please list: ___________________________________
Authorization to Certify for Benefits
I agree the above information is correct and will notify the VA Certifying Official of any changes to
my enrollment, address, status or major so that the VA Regional Office can be notified in a timely manner.
I assume FULL responsibility of reimbursement of funds to UIW or VA should an over-payment
occur as a result of this certification.
I agree that the courses listed are required for my current degree program. If not, I am responsible
for submitting a substitution form for the courses that are not required for the degree.
______________________________________________________
Student’s Signature ***actual signature***
For Office Use Only
Remarks:
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business