Date Received:_______________
Received By:_________________
I am responsible for payment of any portion of the tuition, fees, and books not covered by my VA benefits.
The SCO has the authority to release information and documents to the VA, as they pertain to my educational
benefits and academic progress at Harford.
It is my responsibility to stay informed of policies regarding educational benefits through the Regional VA
office. (
I understand Harford is not involved in the calculation of my BAH. Contact the VA at 1-888-442-4551 with
questions regarding BAH.
I understand the VA will only pay for courses required for my degree. If I am enrolled in courses outside my
degree-plan I will be responsible for the cost of those courses.
VA Certification Request Form
I must submit a copy of my Certificate of Eligibility letter before I can be certified for my first semester at HCC.
_____ Transfer Student previous transcripts required
The VA will not pay for classes outside your degree plan or duplicate classes.
I understand it may take two weeks or longer for my enrollment forms to be processed and submitted to the
VA. Enrollment forms are processed in date order as they are received.
You are responsible for adhering to the following, all students must initial:
I must notify the School Certifying Official (SCO) of any changes to my class schedule before and during the
semester at Failure to notify can create overpayment and debt to the VA.
_____ Other:_______________
I must submit a copy of my DD214 unless I am a dependent, during my first semester at HCC.
I must submit all official college and military transcripts to Records & Registration before the end of my first
semester at HCC. I will not be certified for subsequent semesters until all transcripts are evaluated.
This form must be submitted every semester!
_____ Chapter 1606-Reservist
_____ Chapter 1607-R.E.A.P.
_____ National Guard Waiver
_____ Receiving Pell Grant
_____ Conroy Scholarship
Last Name:_______________________________________________
Harford ID #:_____________________________________________
Cell #:______________________________________________ Home #: ___________________________________________
Declared Major(s): ______________________________________________________________________________________
You must be in a degree-ending major to receive VA benefits. Nursing prep is not permitted.
_____ Guest Student attach parent letter
Mailing Address:________________________________________________________________________________________
City/State/Zip: _________________________________________________________________________________________
_____ New Student at HCC
_____ Returning Student _____ Year attended
Please check all that apply:
_____ Chapter 30-Montgomery GI Bill®
_____ Chapter 31-Vocational Rehabilitation
_____ Chapter 33-Post 9/11 GI Bill®
_____ Chapter 35-Dependent Assistance
_____ Tuition Assistance
_____ In-County Waiver
Please check all that apply:
Office Use Only
____ Fall (turn in by 8/1)
____ Winter (turn in by 11/15)
____ Spring (turn in by 12/10)
____ Summer (turn in by 5/1)
I must verify my enrollment on the last day of every month to the VA in order to receive my monthly benefits
check. I can do this on and click on WAVE or by calling 1-887-823-2378.
I am responsible for paying my tuition & fees to HCC since VA education benefits will be sent directly to me. My
classes will be dropped if payment arrangements are not made with the cashier's office by the tuition due date.
Book stipends are sent directly from the VA Regional Office to me and may not arrive before classes begin.
I must be enrolled in at least 7 credit hours, with at least one of those credits in a face-to-face/hybrid format
for a 15 week semester to receive BAH.
In order for the Vets/Military office to put a hold on my account so my courses will not be dropped for non-
payment, I must submit completed Request for Certification Forms within 10 days of the drop each semester.
Tuition & fees are paid directly to HCC, by the VA, at the In-State rate only. Students are responsible for any
out-of-state difference. If not receiving 100% of the educational benefits I will be responsible for the balance.
The VA requires documentation of mitigating circumstances when you withdraw from a course after the
add/drop period. Mitigating circumstances are documented, unanticipated and unavoidable events that
interfere with the pursuit or completion of a course. Our office must be noticed immediately in the case of
mitigating circumstances at
F-Failure to meet course requirements W-Course withdrawal without a grade (SCO must be notified)
I-Incomplete (SCO must be notified of the date completed) K-Audit-not for credit (SCO must be notified)
I understand 12 credits are equivalent to full-time enrollment during the fall and spring semesters, and I
must remain in 12 credits for the entire 15 weeks of the semester to maintain full-time status. In addition,
summer and winter sessions are calculated by the VA Regional Office and they are based on a semester hour
equivalency (website for VA conversion tool:
The VA Regional Office will be notified if I receive one of the following grades and I may incur a debt with the
Veterans Administration. If the VA warrants an overpayment based on the date of my last attendance, I will
receive a Notification of Debt which will state the amount to be paid back to the VA.
I understand Harford Community College is in no way responsible for any debt owed to the Veterans Affairs
Office for any courses that I stop attending, do not complete, or do not receive a passing grade.
I certify that I have read and understand the information contained in this VA Enrollment Form. I wi
ll contact the
Veteran/Military Office at (443) 412-2100 or the VA at 1-888-442-4551 if I have questions about the information I am
signing. All pages of this form must be completed before my courses will be certified at Harford Community College. If
an incomplete packet is submitted it will be returned to me and processing of my certification will not begin until I
resubmit completed enrollment forms.
I must request that my Voc/Rehab case manager send my 1905, covering the dates of the semester, to
The following statements must be initials by Chapter 35 student:
The following statements must be initials by Chapter 30, 1606, and 1607 student:
The following statements must be initials by Chapter 33 student:
The following statements must be initials by Chapter 31 student:
VA File Number. (Required in order to process your certification and is normally the last four digits of
parent's social security number.)
I am responsible for paying my tuition & fees to HCC since VA benefits will be sent directly to me. My classes
will be dropped if payment arrangements are not made with the cashier's office by the tuition due date.
I will not receive payment for courses I have successfully completed ('D' or better is satisfactory in most
Print Name:
click to sign
click to edit