Registrar’s Office
P: 603-230-4014
F: 603-230-9314
E: NHTIRegistrar@ccsnh.edu
NHTI – Concord’s Community College
31 College Drive, Concord, New Hampshire 03301
603-230-4000 | www.NHTI.edu
Military Student Semester Certification Worksheet
This form must be completed prior to the start of each semester you want your enrollment certified. Return
the completed form to: NHTIVeteranInfo@ccsnh.edu
.
Note: Dropping a class beyond the refund period will create a debt on your student account. Military
education monies will be returned to the VA and/or DOD as required by law. You will become responsible
for paying NHTI for the returned funds. A HOLD will be placed on your NHTI student account until the
balance has been resolved. This will affect registering for any additional classes.
Student’s Name: Student’s ID#: A
Academic Major: DOB:
Telephone/Cell#: Email:
Street Address: Apt. #:
City: State: Zip:
Select one:
Please certify me for the (check one):
NOT Using military benefits for (check one):
Please
indicate which military education benefit you will be using:
Air
Chapter 30 – Montgomery GI Bill (prior active duty)
Chapter 31 – VRE - Veteran Readiness & Employment
Chapter 33 – Post 9/11 Veteran
Chapter 33T – Post 9/11 Dependent
Chapter 35 - VA Dependent
Chapter 1606 – Montgomery GI Bill (Reserves/National Guard/MO Guard)
Tuitional Assistance - NH National Guard Army
Tuitional Waiver - NH National Guard (check one): Army
Other:
By si
gning this form, you allow the release of grades or any other information required by the Department of
Veteran Affairs, National Guard, DOD or other funding agency.
Signature: Date:
03-24-2021
click to sign
signature
click to edit
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