Fillable montgomery college REQUEST FOR CERTIFICATION FOR VA BENEFITS

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montgomery college REQUEST FOR CERTIFICATION FOR VA BENEFITS

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REQUEST FOR CERTIFICATION FOR VA BENEFITS
Email form to VA@montgomerycollege.edu
Fall ☐ Winter ☐ Spring ☐ Summer I ☐ Summer II ☐ Year: _____
Which campus will you take most of your classes this term?
Takoma Park/Silver Spring ☐Germantown ☐☐ OnlineRockville ☐
Last Name ___________________ First __________________ MC I.D. #________________
Note: The DVA requires all students to declare a major at the beginning of their 3rd semester.
☐ Please check if you have changed your major
Estimated Date of Graduation ____________ Major _______________________________
Address: __________________________________________________________________
________________________________________________________________________________
If this is a new address, you must fill out an address change form with the Enrollment Services
Office
E-Mail Address ____________________________ Phone _________________
☐ Chapter 33 (Post 9/11 GI Bill)
☐ I am a veteran/service member
☐ I am a dependent of the veteran/service member (transferred benefits)
Active Duty☐
☐ Chapter 30
☐ Chapter 31 (please check with your VA counselor for course approval)
☐ Chapter 35 (Survivors & Dependents Educational Assistance)
☐ Chapter 1606/1607 (Active Selected Reserves/National guard)
☐ Tuition Assistance TA/ MYCAA
☐Army ☐Air Force ☐Navy/Marine/Coast Guard ☐Army National Guard ☐Air National Guard
☐I am a service member ☐ I am a service member’s spouse
Are you requesting a TA Agreement? ☐No ☐Yes
YOUR STATUS
Continuing student ☐☐ Transfer studentNew VA claimant ☐
☐ Guest student (Permission to Enroll at Another Institution required)
☐ Request to have a HOLD put on my schedule to avoid non-payment deletes
STUDENT ACCOUNTABILITY STATEMENT
I am responsible for payment of all tuition and fees that my VA benefits do not cover.
I understand that completion of this form assures me of enrollment certification with the DVA.
I understand that a hold will be placed on my account that will prevent my classes from being dropped for non-payment. If I decide
not to attend my classes, I am responsible for dropping them and I must notify the school VA Office of any schedule change(s). If I
do not fulfill this obligation my benefits may be delayed. If I drop my classes, I am required to return the funding that I have
been provided.
Signature ____________________________________ Date ________________
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Page 1 of 2
Promissory Note for Veterans Education Benefits
Montgomery College [MC] will not be able to “hold” your classes unless this form is on file along with
your Certificate of Eligibility for Ch. 33.
Name: ________________________________________________________________________
Initial each block:
GI-Bill Chapter 33 Benefits
☐ Certify my class schedule for GI-Bill Chapter 33 benefits. I understand that: 1) The VA will pay the
college a percentage of my tuition and fees if I am determined to be eligible for Chapter 33 benefits. The
percentage of my tuition and fees that the VA will pay the college is based on my active service time since
9/11/2001 as determined by the VA; 2) I am responsible for paying any tuition and fees balance owed to the
college if the VA does not pay 100% of my tuition and fees; 3) I must provide MC’s VA Coordinator with a
copy of my VA Chapter 33 Certificate of Eligibility as soon as it arrives. My VA Chapter 33 Certificate of
Eligibility will state my approved benefit percentage of payment.
☐ I am responsible for purchasing my own textbooks each semester. If I am determined to be eligible, the
VA will award me a book allowance based on my course load.
☐ I understand that the VA will pay me the monthly E-5 married BAH rate for Montgomery County as
long as: 1) I register more than half-time (7+ credits) in a semester AND 2) At least one of my classes is on
campus. I understand that NO monthly payment of BAH will be paid by the VA if I register for less than
half-time (6 credits and under) in the fall and spring semester.
ALL VA CLAIMANTS MUST COMPLETE THIS SECTION
Initial each block:
☐ I understand that I must immediately notify the MC VA Coordinator of any changes made to my class
schedule by me or anyone else under any circumstances (i.e. adds, drops, withdrawals, change of major,
etc.). Failure to notify the VA Coordinator may result in me owing the VA for an overpayment. I
understand that I am responsible for all debts resulting from reductions or terminations of my
enrollment even if the payment was submitted directly to the college on my behalf.
☐ I understand that I must attend all classes to the end of the term.
☐ I understand that I must submit transcript(s) from prior colleges/universities and military schools for
evaluation.
☐ I understand that the VA will only pay for classes required for my degree plan. Each semester, the MC
VA Coordinator verifies all veteran registered classes to confirm each class is required for that student’s
degree plan. I must notify the VA oordinator of any change to my degree plan within 24-hours of a change
being made.
*********************************************************************************************************
Student Signature: ______________________________Date:_____________________
Page 2 of 2
See Page 3 for BHA rates, Stipend Amount and
Training Equivalency table.
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QUALIFICATIONS
EFFECTIVE AUGUST 1, 2019
To qualify for full housing benefit, students must be enrolled in at least one on-
campus class and registered for at least 12 hours.
90% BAH if registered for 11 hours.
80% BAH if registered for 9-10 hours.
60% BAH if registered for 7-8 hours.
Housing, books and supplies stipends are paid “in arrears.” This means that housing
stipend for September will be paid in the first week of October.
Full-time students taking all online courses will receive a housing allowance of
$825.00.
All remedial/developmental courses must be taken in person.
Benefits are prorated based on the percentage of the maximum benefit payable and the number
of credit hours. Example: Students at the 60% level receive 60% of $2,535.00 BAH if full-time.
However, less than full-time will be prorated from the 60% level (see above percentages).
Monthly housing allowance: $2,535.00
Book allowance: $1,000.00 per year (the VA calculates $41.67 per
credit). For example: a full-time student registered for 12 credit hours is
expected to receive ($41.67X12) = $500.04 for the semester.
Tutorial Assistance: $1,200.00 per year (must be enrolled at least half time)
School Comparison tool is available: https://www.va.gov/gi-bill-comparison-tool
WINTER ENROLLMENT
A 3-credit course on campus is considered full time.
SUMMER ENROLLMENT
A 3-credits course that runs for five weeks is considered ¾ time. A 4-credit course for
five weeks is full time. Students should consult the TRAINING TIME
EQUIVALENCY TABLE on the link below to determine their status:
https://www.gibill.va.gov/Training/Spreadsheets/Semester_Hours.pdf
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montgomery college REQUEST FOR CERTIFICATION FOR VA BENEFITS

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Completed 16 April 2020

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