Veteran's Affairs Educational Benefits Packet

Please complete all sections of this online form to help us process your VA benefits as quickly as possible. You are also responsible to read, in its entireity, the information section after the form and sign that you have read and understand the details about your benefits and what is required of you by the VA to receive your benefits.

Name

First NameMiddle NameLast Name

Student ID #

Email*

To maintain student confidentiality, Emmaus Veterans Affairs will only communicate with students using their Emmaus student email address.

Address on file with the VA

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Area CodePhone Number

SSN #

Check semester you are requesting to receive benefits

FallSpringSummer

Choose the VA Chapter from which you receive your benefits:*

For what term are you requesting enrollment certification? Please also indicate the number of hours for which you have registered or are planning to register:

If you add or drop a class during a given term, you must contact the Registrar's office to ensure your VA benefits are correct.

The dollar amount VA Educational benefits may be affected by dropping or adding classes, enrolling in an unauthorized repeat of a class, enrolling in courses not authorized under the general education requirements or degree program designated on your current Veterans Plan of Study.

Receiving non-punitive grades may result in an overpayment by VA. Non-punitive grades are grades that do not count toward graduation and include: “W”, “WP”, “WF”, “I “and failing grades from non-attendance. Students, who receive an “I” in a course, must notify the Emmaus Registrar once the course is completed and a letter grade is issued.

Enrollment status is determined by the number of credits certified. Credits taken but not certified will not be considered by the VA when calculating benefit rates.

I verify that the preceding courses, which I have listed and have registered for, are required in the above stated program of study; they have not been successfully completed previously nor have I received transfer credit for them. I will notify the Registrar/Veterans Affairs Office at Emmaus Bible College of any change in my enrollment (including credit hours).

Have you used VA Educational Benefits in the past?

NO, I have not used my benefits. - Note: If you are a first-time applicant, be sure to complete VA Form 22-1990, Applications for VA benefits at https://www.gibill.va.govYES, I have used my benefits before. - Note: If you have used your benefits at another school, be sure to complete VA Form 22-1995 at https://www.gibill.va.govTOE, Transfer of Entitlement for dependent spouse or child benefits. - Note: If you are a first-time applicant, be sure to complete VA Form 22-1990e, Applications for VA Benefits at https://www.gibill.va.gov

Select your VA program below and submit the requested documents. Unless otherwise noted, all programs require that you send a copy of your DD214 and Certificate of Eligibility to Emmaus.

Please Note: If you do not have a copy of the DD214 or Certificate of Eligibility, you can obtain copies from the US Department of Veterans Services online at http://www.archives.gov

Please check one of the following if you applied for Military Tuition Assistance

After the Military approves your tuition assistance, please send a copy of your Tuition Authorization to:

Emmaus Bible College

Registrar's Office

Attention: VA Certifying Official

2570 Asbury Road * Dubuque, IA 52001

Emmaus Bible College
Veterans Benefit Information & Student Accountability

Please note that you are responsible for all information in this section

The following information applies only to those who have been accepted through the Emmaus Admissions Department into a degree program (AA, BS). If you are currently taking courses but are not in a degree program, please contact the Registrar for instructions on how you might enroll.

To begin the certification process, please complete the following steps:

1. Please print and read the following two documents:
• Class Attendance & Standards of Progress
• Veterans Financial Responsibility to Emmaus & Contact Information

2. Please submit the following completed forms to the VA Certifying Official at Emmaus Bible College:
• Veterans Information & Confirmation of Benefit Program
• Veterans Responsibility to Inform

3. Please download and complete the appropriate form from www.gibill.va.gov and submit to the VA Certifying Official at Emmaus Bible College
• If applying for benefits for the first time, print and complete the Application for Education Benefits (form 22-1990)

OR

• If benefits were used prior to attending Emmaus, print and complete the Request for Change of Program/Place of Training (form 22-1995)

4. Also required is a copy of your DD-214 (member 4) or a NOBE

5. The final document needed is a copy of your enrollment or class schedule. Do not present any of the above documents to Emmaus until this document is secured.

Please submit the required five documents in a single envelope to the VA Certifying Official.

Emmaus Bible College, Registrar, SCO
2570 Asbury Road
Dubuque, IA 52001

Certification of benefits is completed by the end of the Drop/Add period of each semester (within the first two weeks). Please feel free to contact jbennett@emmaus.edu if you have any questions.

Thank you for choosing Emmaus Bible College!

Class Attendance & Standards of Progress

Veterans attending Emmaus Bible College who receive benefits must meet the following minimum Standards of Progress. Should the Veteran fail to meet these minimum standards, Emmaus is required to report to the Veterans Administration that the Student is not meeting the Standards of Progress. A review of academic work and progress will be made at the end of each semester the Veteran attends Emmaus. Failure to meet VA Standards of Progress (class attendance, GPA, etc.) will result in VA consequences (loss of financial aid assistance, etc.).

Class Attendance:
It is mandatory that the student attends class(es) on a regular basis. It is the student’s responsibility to notify Emmaus when the student stops attending class(es) which are in progress. This notice must be in writing and submitted to the VA Certifying Official (Registrar) at Emmaus.

The notice must contain the following information:
• The phrase, "Notice of Termination of Class(es)"
• The date the student last attended class [as verified by the Professor]
• The students' social security number
• The students' signature

Students receiving benefits under Chapters 30, 33, 35, 1606 and 1607, must confirm their attendance on a monthly basis by calling 1-888-GIBILL1 or verifying attendance on the VA website at “Ask A Question”. Students may also use the WEAVE system.

GPA:
It is required that all students progress in a measurable manner to the successful completion of their educational goals. In the case of Veterans, a GPA of 2.0 as set forth by the Veterans Administration must be met each semester for benefits to continue.

Registration:
The class(es) for which the student registers each term must be applicable to the declared program of instruction for which the Veterans Administration has certified the student. Any change in the student’s choice of program of instruction must be made in writing and submitted to the VA Certifying Official at Emmaus.

Credit Hours:
The number of credit hours attempted (reported to the VA) for each semester will be determined as follows:
• For the Fall and Spring on-campus semester, the number of hours for which a Veteran is registered and attending at the end of the second week of class.
• For the Summer on-campus term, the number of hours for which a Veteran is registered and attending at the end of the second day of class.
• For Emmaus Distance Learning students, the number of hours represented by the course upon its completion.

Veterans Financial Responsibility to EBC & Contact Information

Payment and Benefits:
Payment for online and Independent Study courses is due at the time of ordering/enrolling. No course(s) will be received by the Veteran unless payment has been rendered. Payment for on-campus students is due by the payment due date each semester. A three-month free payment plan and a 10-month ($150) payment plan are available for on-campus students only.

Students utilizing their benefits at Emmaus for the first time should expect to wait a period of eight to twelve weeks for the VA office to process the Veteran’s claim. All future transactions will be conducted electronically and therefore, those payments should be received in about two- three weeks. Benefit checks will be mailed directly to the Veteran or deposited directly in to the Veterans designated account via "Direct Deposit".

Independent Study Students:
All Independent Study students should notify the VA Certifying Official at Emmaus upon completion of each course in order to be reimbursed.

Online and On-Campus Students:
Online and on-campus students must provide a copy of their semesters schedule to the VA Certifying Official/Registrar at the beginning of each semester.

Responsibility to Notify:
The Veteran must notify both the VA and the VA Certifying Official immediately of any change effecting:
• Program
• Address or phone number
• Marital status or number of dependents

Notification must be in writing. It is the Veterans’ responsibility to ensure that both the VA and the VA Certifying Official are informed of any changes as soon as they occur. Not doing so could jeopardize current or future benefits. It is important to keep copies of all forms.

Contact Information:

Veteran’ Affairs National Hotline: 888-442-4551
Expert VA counselors are available to answer questions regarding any VA related matter.

Mailing address:
Emmaus Bible College

Registrar, SCO
2570 Asbury Road Dubuque, IA 52001

jbennett@emmaus.edu

Veterans Responsibility to Inform

I understand I cannot claim VA benefits for the following:

• Auditing any class
• Any class that a GPA of 2.0 was not met
• Failing to complete a class before its expiration date
• Any class not specifically in the declared program of instruction for which the VA has certified me

I also agree to provide, when requested, the following information in writing to the VA Certifying Official/Registrar at Emmaus:

• Proof of completion of a class
• Change of address, phone number, marital status or dependents

Directed Study Students:
I (Veteran/Student) understand that I must inform the VA Certifying Official/Registrar at Emmaus when I complete each Independent Study class.

Online and On-campus students:
I (Veteran/Student) understand that I must provide the VA Certifying Official/Registrar at Emmaus with a copy of my class schedule at the beginning of each semester.

I agree to meet the VA’s Standards of Progress as outlined. If I do not meet the minimum standards, I understand that my Veteran benefits will be in jeopardy.

If VA overpays me, I agree to immediately repay the VA the amount determined to be overpaid. If the VA attempts to bill Emmaus for this amount, I agree to reimburse Emmaus in full plus penalties by any deadline Emmaus specifies.

I have read, understood and agree with the above statements and will readily comply.

Student's Signature*

Emmaus Bible College Veteran's Affairs Educational Benefits