Veteran Enrollment Certification Request Form

Financial Aid Office

University of South Carolina Lancaster

PO Box 889 • Lancaster, SC 29721-0889

Phone: 803-313-7068 • Fax: 803-313-7168 • E-mail:

usclfa@mailbox.sc.edu

SUMMER 2016 VETERAN ENROLLMENT CERTIFICATION REQUEST

NAME:

SSN:

______________________________________

VA FILE #:

ADDRESS:

DAYTIME PHONE:

HOME PHONE:

DEGREE:

_____________________________

GRADUATION (Month/Year): ____________________

MAJOR/INTEREST: _________________________________________________________________________

BENEFIT ELIGIBILITY (indicate the program for which you are eligible)



Chapter 33

Post 9/11 GI Bill



Transferred Ch. 33 Post 9/11 GI Bill Transferred to Dependent (Certificate of Eligibility Required)



Chapter 30

Montgomery GI Bill — Current/Former Active Duty (DD-214 Required)



Chapter 1606

Montgomery GI Bill — Selected Reserve (NOBE Required)



Chapter 1607

Reserve Educational Assistance Program –REAP (NOBE Required)



Chapter 35

Dependants’ Educational Assistance (Certificate of Eligibility Required)



Chapter 31

Vocational Rehabilitation Program (28-1905, signed by case worker, Required)



Is this a change of Major?

(VA form 22-1995 or 22-5495, except for Ch. 33)

YES



Are you a transient student?

“Home” institution: _____________________

YES

ENROLLMENT STATUS

Indicate your projected semester credit hours for the applicable terms:

(enrollment status is for VA purposes only)



Maymester (2 1/2 weeks)

05/09/16 to 05/27/16

6 hrs = Full time, 4 hrs = ¾ time, 3 hrs = ½ time



SUMMER 1 (4 weeks)

05/30/16 to 06/28/16

6 hrs = Full time, 4 hrs = ¾ time, 3 hrs = ½ time



SUMMER 2 (4 weeks)

07/05/16 to 08/05/16

6 hrs = Full time, 4 hrs = ¾ time, 3 hrs = ½ time

*Note: For Ch 33, you must be enrolled in at least 7 credit hours to qualify for BAH (housing allowance).

All courses to be certified must be required for the major indicated above.

SPECIAL APPROVAL is required if any of the above courses are correspondence, independent study, open

circuit ETV, practicum or internship. Contact the VA coordinator for further information.

PLEASE READ AND SIGN ACKNOWLEDGEMENT AND UNDERSTANDING OF THE FOLLOWING

STATEMENT: The information I have provided on this form is true. I understand that it is my responsibility to

notify the USC Lancaster VA Office of any changes in my degree program or projected semester/term hours

(including drops, withdrawals, and petition for grade changes). I also understand that if I withdraw or fail a course

due to excessive absences or non-attendance in class, I may be required to repay any money received (from the

VA for the courses failed or withdrawn).

____________________________________________

__________________________

Student Signature

Date

L:VA Benefits2015-2016Summer 2016 Enrollment Certification Request Form.docx

Veteran Enrollment Certification Request Form - 2016

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