Complete and submit this form for CA certification.
Date
-
Month
-
Day
Year
Date
Last Name
*
First Name
*
Student ID
*
Major
Level
Undergraduate
Graduate
Please select term:
Fall
Spring
Summer
Year
Please Select
2024
2025
2026
2027
2028
I will be using the following benefits (Please check all that apply):
Chapter 33/Post 9/11 GI Bill®
Yellow Ribbon (Must be 100% for eligibility)
Chapter 31 – VR&E
Chapter 35 – Dependents Education Assistance
Chapter 1606 – Select Reserve/National Guard
Chapter 30 – Montgomery GI Bill®
Percentage
Memorandum of Understanding
I understand that I am responsible for paying all balances on my account not paid for by the VA.
I understand that the Assumption University School Certifying Official will only certify my benefits to the VA once I have returned all requested information, including the Request for Certification form each semester.
I understand that the VA determines my eligibility for benefits.
I understand that if I have questions about my benefits, I can call the VA at 888‐442‐4551.
I understand that the VA might require me to verify my enrollment at the end of each month before they will release my monthly payment (this applies to all benefits except Ch. 31 & Ch. 35).
I understand that I am responsible for paying for any housing and meal plans because the VA does not pay for these.
I understand that the VA calculates dropped classes differently than colleges do and I may owe a balance due to Assumption University after dropping classes.
I understand that it is my responsibility to notify the Assumption University School Certifying Official when I add or drop classes. Any delay can result in incorrect payments and possible debt from the VA.
I understand that the VA requires the School Certifying Official to subtract any tuition and fee related grants and scholarships from the reported tuition and fees which could leave a remaining balance that I am responsible for.
I understand that the VA expects me to attend all classes that I am registered for and that the School Certifying Official is required to report a last day of attendance for all failed classes which could result in a debt owed to the VA.
I understand that when I exhaust my benefits, there may be a balance remaining on my student account that is my responsibility to pay.
By signing below, I acknowledge that I have read and understand the above statements.
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