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Phone: (415) 442-7283 E-Mail: Fax: (415) 442-7819
VA Educational Benefits Certification Request
This form must be completed by students requesting to use VA educational benefits at GGU. This form should be
submitted prior to the beginning of each term for which benefits are being claimed. For questions about this
form or your VA benefits, please email our School Certifying Official (SCO) at
Name: GGU ID:
Spring Summer Fall
VA Chapter:
Ch 30 (Montgomery Active Duty)
Ch 31 (Vocational Rehab)
Ch 32 (VEAP)
Ch 33 (Post 9/11) @ %
Veteran Dependent
Ch 35 (Survivors and Dependents)
Ch 1606 (Reserve)
Active Duty Tuition Assistance (TA)
Branch: ____________________
Student Status:
First-time student (Transfer)
Continuing student
Guest student (Include
Parent School Letter)
Grade Level:
Total Units in Each Term:
Term A (15 weeks)
Term B (7.5 weeks)
Term C (7.5 weeks)
MAC/MSA Cohort
MST Cohort
Additional Required Documents/Actions Needed:
Vocational Rehab (Ch 31):
Please make sure your Voc. Rehab counselor submits your authorization to us via Tungsten.
First-time student at GGU (Ch 33):
Complete the application for VA educational benefits at
Attach a copy of your letter of eligibility (COE, award letter, or ebenefits printout from
Attach a copy of your DD-214 (Member 4).
Transfer students: also need to complete and submit VA form #22-1995.
Continuing Students (Ch 33):
Attach a copy of your most recent letter of eligibility or Education Enrollment Status printout of
ebenefits from
Dependents (Ch 33):
Apply for transfer of benefits at
Attach a copy of your Transfer of Eligibility (TOE) form and dependent’s COE.
Dependents Educational Assistance (Ch 35):
Attach a copy of your letter of eligibility and include the following:
File # Suffix (A, B, C, D, E)
Selected Reserve (1606):
Attach a copy of your Notice of Basic Eligibility (NOBE).
Active Duty Tuition Assistance:
Each branch has its own application process and criteria for eligibility. Therefore, please contact your
duty stations Education Office to learn more about your available benefits and submit your approved
contract with this form.
Updated 2/11/20
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Course Certification
I will be registering for the courses listed below and have verified that the courses follow my Path to Completion
(P2C) and/or I have checked with my advisor to make sure I am taking the correct courses for my program of study.
By submitting and signing this form, I acknowledge, understand, and agree to the following:
It is my responsibility to know what classes count toward my approved degree program, work with my Academic Advisor
to plan a viable P2C, and enroll in those courses accordingly. The VA will only pay benefits for courses that are part of
my approved degree program that have not been previously completed with a passing grade except when rounding out.
“Round –out” may only be used in the final semester of attendance. If I enroll in non-required or repeated courses, I
will be responsible to Department of Veterans Affairs (DVA) for any overpayment.
I am required to e-mail if I make any changes to my registration, including dropping or withdrawing from
a course. I will be responsible to the DVA for any overpayment due to registration changes after the drop/add period,
which may result in loss of benefits effective the first day of classes.
The best time to change my major or concentration is after the term has ended, because changing my major midterm will
affect my VA benefit or cause an overpayment to occur.
At the end of the term, VA will be notified of my last day of attendance for any/all courses where I earned the following
grades: W (Withdrawal), UW (Unofficial Withdrawal), or an F (Failing). Receiving any of these grades may result in an
overpayment of tuition and housing benefits which I would be responsible for paying back.
I must maintain satisfactory academic progress as defined in the GGU student handbook. I further understand that
Incomplete grades must be completed by the end of the subsequent semester.
If my current GGU GPA falls below 2.0 (Undergraduate) or 3.0 (Graduate) in any term, I will be on Academic Probation
the School Certifying Official (SCO) will notify the VA. I will need to improve my academic standing or my veteran benefits
may not be certified. This could delay my receipt of benefits.
Audited courses are not eligible for certification.
I am responsible for payments of tuition and fees not covered by the VA by term due date.
I understand that in order to receive the maximum San Francisco Basic Allowance for Housing (BAH), I must be enrolled
in full-time units and at least one of the classes must meet the VA’s “RESIDENCE” (in-person) criteria. The
RESIDENCE criteria can be met by taking a class in one of these instructional methods: In-person, Mixed Mode or
I understand that I must attend at least one in-person class meeting for the class to qualify as the RESIDENCE class for
housing benefits. However, I must also attend any additional in-person requirements as set by the instructor to
successfully meet the class’ academic requirements. Failure in doing so, dropping or changing your instructional method
or class, could result in a debt owed to the VA. Failure to do so may result in my certification being updated to an ON-
LINE class which will affect my BAH amount. Consequently, the VA may determine overpayment of tuition and housing
benefits for the semester and request repayment from me.
I understand that the DVA calculates my Monthly Housing Allowance (MHA) using the start and end dates per the published
academic calendar as certified by the SCO.
I understand that while VA payments should come on a regular basis, this is not guaranteed by GGU or the VA Regional
Office. Therefore, I understand that I must plan accordingly to make sure I can adequately cover my living expenses.
Signature Date GGU ID
Yes or No
Yes or No
Drop /
Updated 2/11/20
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