How many online classes are you enrolled in?
The following forms must be submitted to the VA Certifying official prior to initial certification of benefits:
Application for Admission (only required prior to enrollment, not each term)
Certificate of Eligibility (received after applying for benefits).
Official High School transcript or GED Certificate if applicable.
Official Transcripts from ALL post-secondary schools.
Your semester schedule
This form should be completed every semester by all students using VA Education Benefits.
Semester (Please Check):
FALL
SPRING SUM
MER
Year:
Last Name First Name Phone Number
Address City State Zip
VA File # Social Security Number Date of Birth
Major Email
Please list all post-secondary school schools attended:
MILITARY BENEFITS CERTIFICATION FORM
VA School Certifying Official: Stacia Sparrows
(252) 335-0821, ext. 2258
stacia_sparrows41@albemarle.edu
30 31 33 35 1606 1607
Yes No
Benefit Chapter Please Check:
Ar
e you currently on active duty? Please Check:
Ar
e you a Veteran or dependent? Please Check:
1.
Have you applied for VA Education Benefits? Yes No
If no, complete an application for benefits VA f
orm 22-1990 at http://vabenefits.vba.gov/vonapp/main.asp
2.
Have you ever used VA Education Benefits at another college? Yes No
If yes, you must submit VA Form 22-1995
3.
Are you repeating courses? Yes No
4.
Are you enrolled in a Hybrid Class? Yes No
Veteran Dependent
Print
Save As...
Reset Form
Classes outside of your major cannot be certified
Classes (with a passing grade) cannot be certified if repeated
Audited classes, independent study classes, credit by exam, classes for which transfer
credit has been awarded, or any other classes not counting toward graduation cannot
be certified
Developmental classes taken on line cannot be certified (only face to face
developmental classes can be certified)
Chapter 30, 1606, and 1607 are required to report enrollment status on the last calendar
day of each month at www.gibill.va.gov/wave/index.do or 1-877-823-2378
For normal terms, full time VA benefits will be paid if enrolled in 12 or more credit hours.
For summer or any other non-standard term, the VA will compute payments based on
hours and term length.
Chapter 33 students only: A reduced amount of BAH will be received if enrolled
exclusively in virtual courses (online/hybrid)
You must attend class to receive VA education benefits. It is your responsibility to
immediately notify the SCO if you add or drop a class, withdraw from a school, or stop
attending for any reason. Students may be responsible for overpayments resulting from
any of the above listed changes.
You must meet the COA and North Carolina State Approving Agency standards of
progress, meaning you must maintain a cumulative GPA of 2.0 or higher. You may not
be certified for VA benefits beyond two consecutive terms while below the standards of
progress. If you have extenuating circumstances, you may have the option to appeal.
If you change your program you must complete a program change form and notify your
SCO. Failure to do so could delay your benefits.
You are required to pay for all charges at the time of registration. The Department of
Veteran Aairs will make payments of education benefits and COLA (if applicable) to
you as long as you have the entitlement.
Note: Chapter 33 (post 911 GI bill) and Chapter 33 (Vocational Rehabilitation) may be
exceptions.
Students are required to notify their SCO at the beginning of the semester that they
intend to graduate. If needed, students may “round out” their final term and take a class
outside their major to be considered full time.
For more information about benefits including housing allowance, book stipend, etc., visit the GI Bill website at:
www.gibill.va.gov/resources/benefits/resources. You may also apply for financial aid at www.fafsa.gov. Please make
sure to add COA’s school code – 002917.
I have read the information on both sides of this form and understand my responsibilities:
Printed Name Signature
COA Student ID Date
STUDENT GUIDELINES AND RESPONSIBILITIES
Register for
the Correct
Classes
Reporting
Enrollment
Enrollment
Status
Attending
Class
Satisfactory
Academic
Progress
Changing
Majors
Tuition
Graduation
click to sign
signature
click to edit
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome