San Diego Community College District
Semester Worksheet
Fall Spring Summer Year:
City Mesa Miramar
(Indicate Primary Campus)
Student Name:
(PRINT) Last First MI
SSN/VA Number: Student ID Number:
Major: Has your major changed since you were last certified? Yes No
Mailing Address:
Street City State Zip
E-mail: Telephone:
VA Education Benefit Type (Transfer Entitlement: Yes No)
Post-9/11 MGIB Reserve Voc Rehab DEA VRAP
(Ch. 33) (Ch. 30) (Ch. 1606/1607) (Ch. 31) (Ch. 35)
Counselor Signature: Date:
WITHDRAWAL/CHANGE OF CLASSES: I understand that as a condition of attendance in the San
Diego Community College District, I am required to notify the VA Office whenever I add/drop any
course that is payable by the VA Regional Office. These changes must be reported immediately.
FEE DEFERMENT: I understand that I will be responsible for paying for any outstanding fees not
covered by my VA educational benefits. I will have a hold placed on my account and will not be able to
register for classes in subsequent semesters until the balance is satisfied.
REPEATED CLASSES: Veterans may not receive benefits for a repeat of a course in which a grade of
"A," "B," "C," "D," or "P" has already been earned. Although District policy allows a student to repeat a
course in which a "D" grade has been received, the repeat course may only be certified for benefits if
the catalog states that a grade of "C" or better in that course is required to earn a degree or meet a
prerequisite.
Student Signature: Date:
Distribution: Veterans Affairs Office
SS-VA/SMSTRWS 07/2019
LIST CLASSES HERE
(Do NOT include classes you are waitlisted for)
NOTE: The VA will NOT pay for online or hybrid basic skills/remedial courses.
Course
Subject
(Example: HIST)
Course
Number
(Example: 101)
Number
of Units
Is this an
Online or
Hybrid
Course?
Class Start & End
Dates
OFFICAL USE ONLY
Last Day of
Attendance
(LDA)
Meet Ed Plan
Requirement?
VA OFFICE ONLY
Staff Initials
Ed Plan
Orientation
Vet.Status Pg
click to sign
signature
click to edit
click to sign
signature
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OFFICIAL USE ONLY
Date Name Comment/Remarks