Veteran Affairs (VA) Benefits Submission Form

Veteran Affairs (VA) Benefits Submission Form

Please complete this form in its entirety, ensure that your signature is included and that your Certificate of Eligibility (COE) is uploaded. This form can not be submitted without uploading a COE.

Please note that for Chapter 35/ Survivors and Dependents Educational Assistance benefits, a Sponsor SSN is required.

Last Name*

First Name*

Middle Initial

Student ID*

Semester to be Certified *

Select

Semester Year*

Student SSN

DOB

Home Address*

City*

State*

Zip Code*

Phone Number*

Major*

Minor

Spelman Email Address*

I am a dependent using transferred Post 9/11 benefits.*

Select

VA Educational Benefit:*

Post-9/11 GI Bill (Chapter 33)

Veteran Affairs Educational Benefit:*

Post-9/11 GI Bill (Chapter 33)

Montgomery GI Bill Active Duty (Chapter 30)

Survivors’ and Dependents’ Educational Assistance (Chapter 35)**

Veteran Readiness and Employment (Chapter 31)

Montgomery GI Bill Selected Reserve (Chapter 1606)

Veteran Sponsor SSN (required for Survivors’ and Dependents’ Educational Assistance/Chapter 35)*

Veteran Sponsor First and Last Name*

Please carefully read all responsibilities as a Veteran Affairs Benefits recipient.

It is my responsibility to ensure that I register only for courses required for my program of study. I understand VA will only pay for courses used towards my degree.

I understand as a dependent using any chapter VA educational benefits, that the VA Certifying Official will not discuss my VA benefits with a spouse or parent(s) unless there is a FERPA signed release form placed in my Veterans Affairs file.

It is my responsibility to provide the Veterans Affairs Certifying Official a copy of my Certificate of Eligibility issued by the Department of Veterans Affairs.

I understand I must immediately report any of the following changes to the Veterans Affairs Certifying Official: Withdrawal from Spelman College, Dropped Courses, Added Classes, and Change in Major/Concentration/Minor. Failure to do so will result in suspension or denial of future benefits and/or require repayment of benefits already received.

I understand that strict adherence to Satisfactory Academic Progress (SAP), personal conduct, and class attendance must be followed in accordance to policies printed in the Student Handbook.

I understand that Chapter 33-Post 9/11 Educational Benefits pay tuition to Spelman College. If there is an overpayment of funds and a refund occurs, it is my (student) responsibility to pay any overpayment back to VA.

I understand if changes are made to the original schedule submitted to the Veteran Affairs Certifying Official for certification that such changes could incur charges resulting in a balance due.

If I have any questions regarding the receipt of funds, I understand I should first contact the Veteran Affairs Certifying Official to verify my Enrollment Certificate has been submitted to the Atlanta Regional Office and then I will contact the VARPO for all money issues at 1-888-442-4551.

Check here to indicate that you have read and agree with the above terms.*

Upload Certificate of Eligibility*

Drag and drop files here or

Electronic Signature*

Send me a copy of my responses

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