Fillable VA ENROLLMENT CERTIFICATION REQUEST (Snead State Community College)

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VA ENROLLMENT CERTIFICATION REQUEST (Snead State Community College)

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VA ENROLLMENT CERTIFICATION REQUEST
First and Last Name (Please Print): _____________________
Student ID: _______________________
Credit Hours: _______
Semester: _____________
Program/Major:____________________________
I will contact the VA School Certifying Official at Snead State Community College if changes
occur to my enrollment status for the term specified above. Below is a list of all the course(s) that
I am registered for this semester.
Please List course(s) that you are registered for: (Example: CIS 146)
Course 1:_________________
Web Full Term
Blended Mini I
Residential Mini II
Course 2:_________________
Web Full Term
Blended Mini I
Residential Mini II
Course 3:_________________
Web Full Term
Blended Mini I
Residential Mini II
Course 4:_________________
Web Full Term
Blended Mini I
Residential Mini II
Course 5:_________________
Web Full Term
Blended Mini I
Residential Mini II
Course 6:_________________
Web Full Term
Blended Mini I
Residential Mini II
I certify that all information on this form is complete and accurate. I understand that withholding
information requested or giving false information may result in my enrollment NOT being
certified. I certify that I have only listed courses in my degree plan.
________________________ _______________________ ____________
Student Signature Email Date
________________________ _______________________ ____________
Advisor Signature Email Date
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VA ENROLLMENT CERTIFICATION REQUEST (Snead State Community College)

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Completed 29 January 2021

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