VA Authorization Form

Military Enrollment/Veterans Affairs Enrollment Certification Request Form All Students using Veteran Educational Benefits must complete this form. Failure to do so will result in one or more of the following: a)Enrollment hours not being reported to the Department of Veteran Affairs b)Delay in reporting schedule changes which can result in money owed to Albany State University and/or the Department of Veteran Affairs c)Schedules being dropped for non-payment

Student ID Number*

First Name*

Last Name*

Student ASU Email Address*

Phone Number*

Term*

Select

If you need back pay please email veterans@asurams.edu

Student Status*

New Student

Continuing Student

Transient Student

Enter Veteran/Sponsor First and Last Name

Enter Social Security Number of Veteran/Sponsor

Do you have your Certificate of Eligibility from the Veterans Administration?

Yes

File Upload - Please upload your Certificate of Eligibility document

Drag and drop files here or

Have there been any changes to your VA education benefits?

Select

Please explain

Are you planning on using Veteran Readiness and Employment (Chapter 31)?*

https://www.va.gov/careers-employment/vocational-rehabilitation/

Select or enter value

Are you planning on using federal Tuition Assistance (TA)?*

https://www.militaryonesource.mil/education-employment/for-service-members/preparing-for-higher-education/how-to-use-the-military-tuition-assistance-program

Select

I understand the classes I enroll for the above term must be required for the major listed in Banner to be reported for educational benefits. If I withdraw from classes at any time during the semester I may create a debt to the Veterans Administration or Albany State. This form is required by the Office of Military and Adult Education every semester in order to receive Department of Veterans Affairs Educational Benefits. I understand the failure to turn this sheet in, to provide truthful information, or to properly complete this form in a timely manner will result in the delay of my Certification of Enrollment.

Type full name for signature*

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