
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?
Staff Initials
Ed Plan
Orientation
Vet.Status Pg
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