Veteran Enrollment Certification Form

Veteran Enrollment Certification Form
If you need assistance with this form, contact Mid Michigan College Financial Aid at Phone (989) 386-6664 or finaid@midmich.edu.
Student Name*

First NameMiddle NameLast Name
Mid Michigan College Student ID Number*
You can find your Student ID Number on your Mid Michigan College Student ID Card or in myMid.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Student Email Verification

To complete and submit this form, you must verify your Mid Mich Email.
Enter Your Mid Mich Email*
You MUST provide a Mid Mich Email so that we can verify your identity. Other emails will not be accepted and you will be unable to complete this form.
ERROR The email you entered is not a Mid Mich Email. In order to complete this form, you must enter a MidMich Email so we can verify your identity.
Re-enter your Mid Mich Email for verification, Click 'Verify Email', and follow the directions.*
Program of Study*
Other than your GI Bill, do you receive any aid specific for paying tuition (examples: Federal Tuition Assistance, MINGSTAP, Faculty/Staff/Native American Waiver, etc.)? Enter yes or no, and if yes, please specify.*
GI Bill Benefit Election
Select your GI Bill Benefit Election. You may only select one.*

Chapter 33 - Post 9/11 GI BillChapter 30 - Montgomery GI Bill - Active DutyChapter 1606 - Montgomery GI Bill - Selected ReservesChapter 31 - Vocational RehabilitationChapter 35 - Survivors' & Dependents' Assistance
Click Here for additional information regarding how to submit your monthly verification for the Chapter 33 benefit.
The VA requires you to verify that you are attending your courses each month online at gibill.va.gov/wave or by phone at (877) 823-2378.
Veteran's Name*

First NameLast Name
Entitlement Percentage*
Case Worker's Name*
VA File Number*
Select the semester for verification.*

FallWinterSummer
Do you plan to attend*

Full-Time (12 or more credit hours)Three-Quarter Time (9-11 credit hours)Half-Time (6-8 credit hours)Less than Half-Time (5 credit hours or less)
- Registration changes, enrolling in an unauthorized repeated course, or enrolling in a course not required to fulfill my stated educational objectives may change my eligibility for GI Bill educational benefits and create a debt with the VA.
- I must register, and/or make changes to my enrollment, with my Mid Mentor.
- I must attend courses and make satisfactory academic progress as defined by the Satisfactory Academic Progress Policy in the Mid Michigan College Catalog.
- I must complete a new GI Bill Enrollment Certification Request Form each semester.
- I must report the receipt of federal tuition assistance to Mid Michigan College.
My signature below confirms that I understand and agree to abide by the guidelines stated above.
Student Signature*

Clear
Date*

MonthDayYear
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Veteran Enrollment Certification Form

Student Email Verification

GI Bill Benefit Election