Veteran's Benefit Information Form (Green Sheet)

Name*

First NameLast Name
Student ID#*
Student Social Security Number*
Student Email Address*
example@siue.edu
Student Phone*

Area CodePhone Number
Reason for Request*

I registered for classes and want to use my benefitsI revised my class schedule (added, dropped or changed sections)

Academic Information
Term*

FallSummerSpring
Please submit a separate Veteran's benefits information form request for each semester (Ex. if you are registering for both summer and fall semesters, you will need to submit this form twice: once for summer and again for fall.)
Year*
Degree/Emphasis*
AAS is not a program, please be more specific
Would you like to have all of your classes certified by the VA for this semester?*

YesNo
Courses I'm enrolled in and would like certified*
Format as: SUBJECT NUMBER [SECTION or Online/In-Person]. Class titles not needed
Courses I'm adding
Format as: SUBJECT NUMBER [SECTION or Online/In-Person]. Class titles not needed
Courses I'm dropping
Format as: SUBJECT NUMBER [SECTION or Online/In-Person]. Class titles not needed

Certification Terms and Conditions

All information on this form is protected by FERPA rules and regulations.
- Requests for enrollment certification must be submitted each semester by completing this Request for VA Certification form.
- Remedial classes must be in person for the VA to pay for them. This includes CCR 092, CCR 094, MAT 050, MAT 055, and any other course whose number is less than 100.
- Any adds, drops, withdrawals, class cancelations, or changes of program made to your schedule after your Request for VA Certification has been submitted must be reported immediately to the School Certifying Official and may result in the VA creating a debt against you that you would be required to reconcile.
- A student must be in an approved-by-VA program in order to receive benefits; only courses that satisfy an approved program's requirement as outlined by the catalog will be certified to the VA.
- SIUE student email account is the official means of communication between the college and the student. It is the student's responsibility to check their account on a regular basis.
- A student may only receive benefits for those courses within the program of study (or pre-requisites).
- A student may receive benefits while repeating a course only if it is required for the program of study. The student can not repeat and receive benefits for a course previously completed with an acceptable grade within the program.
- Federal regulations require that any financial aid awards designated for the sole purpose of defraying tuition and fees be used before Chapter 33 benefits may be applied toward your tuition and fee charges. This aid, which includes but is not limited to the MAP grant, Illinois Veterans Grant, Illinois National Guard Scholarship, MIA POW scholarship, vocational rehabilitation, and child of employee tuition waivers, will be paid towards your tuition and fees first and the V.A. will reduce the amount of your Chapter 33 tuition and fee payment so the combination of funds doesn’t exceed your total tuition and fee charges. Contact Student Financial Aid if you have questions regarding the use of your financial aid.
Additional Information

Please remember:
- Contact Military and Veteran Services for assistance. 618-650-5425
- Federal Financial Aid can pay in addition to military benefits. FAFSA opens on October 1st each year for the following school year.
- Turn in your CCAF or JST and your DD214 to the Transfer Center for credit evaluation.
I understand that any changes that I might inadvertently make to other in-progress semesters are my responsibility, even if a change I make creates an unexpected debt. If in doubt, I will contact the Office of Military and Veteran Services.
I certify that all information entered into this form is correct and accurate to the best of my knowledge
Opt-in for texting in order to receive messages during the semester about important items related to your admission and enrollment at SIUE.
Signature*

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Academic Information

VA Benefits and Status

Certification Terms and Conditions

Additional Information