Cabell-Huntington Health Department stay at Home Advisory – READ UPDATE

Veterans Certification Request

VA Benefits Terms Agreement

I am aware I must fill out this form each semester after registering for classes to receive benefits. Only degree applicable courses will be certified. I understand that courses that deviate from the standard term are certified separately and may affect VA rate of pay. Due to processing time, adjustments in enrollment status may result in overpayment of benefits. The completion of this form authorizes the School Certifying Official to certify enrollment and provide academic record information to the Department of Veteran Affairs to ensure the receipt of Educational Training Benefits. A declared major must be reported to the VA by the end of the second semester. It is my responsibility to notify the School Certifying Official immediately upon adding, dropping, or withdrawing from a course. I certify to the best of my knowledge the information below is accurate and complete. In consideration of my admission and enrollment, I, the undersigned, do hereby agree to assume and pay any and all costs associated with said admission and enrollment not paid by the VA directly to the College.

I have read and agree to the above statement(Required)
Name(Required)
Address(Required)
MM slash DD slash YYYY
Check here if you have changed your major since last certification
Do you receive (check all that apply)

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