Veterans
Veterans Enrollment
Certification Request Form
Instructions
The HFC certifying official will review classes provided on the educational plan and transcripts
of previously attended institutions. This will determine courses which will be submitted to the
Veterans Affairs Department for consideration. Transcripts of all institutions previously
attended will be necessary to ensure best customer service. Accuracy of information provided
will impact your timeframe and whether the U.S. Department of Veterans Affairs will fund
coursework.
Chapter information must be provided to begin certification process. If you are unsure of what
benefit, visit www.gibill.va.gov.
Submit completed form to Welcome Center drop box, Email to veterans@hfcc.edu, Fax to
313-845-6464, or Mail to:
Welcome Center
5101 Evergreen Rd
Dearborn, MI 48128
Student Information
Last Name: ____________________ ____________________ ____
____________________
First Name: M.I.:
HANK ID Number:
Current Address: ____________________ ____________________
____________________ ____________________
City/State/Zip code:
Phone: Email Address:
Veteran Reservist/National Guard member Dependent/Spouse of Veteran
VA Educational Benefit Chapter: ____________________
Semester and year you would like to be certified for: (Ex: Fall 2013)
Fall ____ Winter ____ Spring ____ Summer ____
Veterans
Veterans Enrollment
Certification Request Form
___________ _
Certification Information
List all classes that you have registered for in the semester indicated above. Only courses which
comply with VA certification guidelines are eligible for certification.
Current HFC Academic Program of Study:
____________________________________
Course Section Credit Hours Course Date Added Dropped
(ie. ENG) (ie. 132-01) (ie. 8/23/13 12/15/13)
Total Hours:
Veterans
Veterans Enrollment
Certification Request Form
Authorization
The completion and signature of this form authorizes Henry Ford College to certify enrollment for the
courses listed above if they meet certification compliance guidelines with the Department of Veterans
Affairs to ensure consideration for Educational Training Benefits. You understand that you must
submit this form each semester and notify the HFC Office of Veterans Services of any changes to
your schedule. You acknowledge that the Department of Veterans Affairs will determine what
courses will be funded and that you will be responsible for balances due as a result of denial or
change in funding or non-attendance.
Signature: ____________________________________ Date: ____________________
Submit completed form to: Welcome Center DROP BOX, email to VETERANS@HFCC.EDU or
FAX to (313)845-6464
Welcome Center * 5101 Evergreen Rd * Dearborn, MI 48128
Phone 313-845-9688 * E-mail veterans@hfcc.edu
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