Rev.07.31.2019
Request for Certification of Enrollment
ASU VETS Center
Houston Harte University Center, Room 113
ASU Station #11040
San Angelo, TX 76909-1047
(325) 486-VETS Fax: (325) 942-2080
__________________________ __________________________ ______ _____________
Last Name First MI Campus ID
______________________________________________ __________________@angelo.edu
Mailing Address ASU Email
_____________________________ _______ ______________ _____________________
City State Zip Code Telephone Number
Graduating This Term
Y / N
Active Duty
Y / N
Please Indicate the VA Benefit:
Veteran
Ch. 30 – Montgomery GI Bill
Ch. 31 – Vocational Rehabilitation
Ch. 33 – Post-9/11 GI Bill
Ch. 1606 – MGIB Select Reserve
Dependent
Ch. 35 – Survivors and Dependents
Educational Assistance
Ch. 33T – Post-9/11 GI Bill Transfer
of Entitlement
The Angelo State University, above, authorizes the VETS Center Certifying Official to certify
his or her upcoming classes to the Veteran Benefits Administration.
I understand a failure to inform the VETS Center of changes to my class
enrollment, or failure to submit a new Request for Certification of Enrollment
prior to the start of a semester, may result in a delay in processing of my benefit
and may result in a balance due to ASU or the VA and/or deletion of my class
schedule due to non-payment.
Signature: ________________________________________ Date: __________________
Initial
Fall
Spring
Summer I
Summer II
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