Certification of Enrollment for Military Benefits

Name *

First Last

Student ID *

Phone *

Email *

Location

You have my permission to certify my enrollment to the VA for the following semester: *

Attach a copy of your final schedule: *

Note: If you make any changes to your schedule after this submission, please communicate them immediately to your certifying official.

I am using the following Education Benefits: *

(Check all that apply)

Please explain "other": *

Statement of accuracy *

Name

This field is for validation purposes and should be left unchanged.