Veteran/Dependent Enrollment
Certification Request – All Chapters
_______________________________________________________
Name: Last
First
M.I.
_______ - _______
UFID
___________________
(V.A. File Number)
Current Educational Objective: _____________________________ Major, if applicable: __________________________
(certificate, Bachelor, Master, PhD, etc.)
Phone Number (____) ____________________ GatorLink E-mail Address: ____________________________ @ufl.edu
SECTION A: Benefit Information
1)
I am: _________ Undergraduate
2) Benefit Chapter (check only one):
____ Veteran Chapter 30 ____ Dependent Chapter 35 ____ Voc Rehab Chapter 31 ____ REAP Chapter 1607
____ Selected Reserve Chapter 1606
____ Post 9/11 (Chapter 33) Veteran or Dependent (circle one)
(NEW 1606 - MUST provide a copy of NOBE)
3)
I am on active duty ___Yes ___No.
If yes, and are you receiving aid from the Department of Defense – what type?
________________________________________ (Active Duty TA, Reserve TA, Top Up, etc.).
4)
If you answer yes to any questions listed below, please contact the UF Veterans Office in 222 Criser Hall.
5)
________ Graduate/Professional
I am Dual Enrolled at UF and ___________________________________________.
I am enrolled as a transient/non-degree student from ________________________.
Date Stamp
If you answer either of the questions listed below and you HAVE NOT previously
filed the appropriate paperwork, please contact the UF Veterans Office in 222 Criser
Hall or by phone at (352) 392-1374, ext. 7413.
I am pursuing a dual degree/double major or a minor ____Yes ____No
I am repeating a course for which I previously received credit for ____Yes ___ No
I am changing my major or degree objective ____Yes ___ No
I am participating in an Overseas Study Program ____Yes ____No. If yes, what term ______.
I am taking classes that follow the published University of Florida calendar ____ Yes ___ No
(www.registrar.ufl.edu/catalog/adhub.html) If no, please provide a syllabus for each class.
The UF Veterans Office must receive this information by the end of the first week of classes
or you may experience a delay in benefits.
6)
I am: ______ A former UF student returning to UF after an absence of two or more semesters.
I have been cleared for readmission ____Yes ___ No. If no, please contact the UF Veterans Office.
I am: ______ A continuing UF student that is receiving benefits (go directly to Section C).
SECTION B: Students who have never used/received benefits at UF (check all that apply)
1)
____ I have never used VA benefits at any institution and:
(a) have attached my certificate of eligibility OR
(b) VONAPP Confirmation Number: ___________________ Date Submitted: __________________________
2)
____ I am a new student to UF who has received VA benefits at another institution.
I have completed a 22-1995 (CH 30, Chapter 33 Post 9/11 Veteran, 1606 or 1607) OR 22-5495 (CH 33-Post 9/11 Dependent or Chapter 35) Change of Place of Training form at www.gibill.va.gov
VONAPP Confirmation Number: _________________ Date Submitted: _________________
3)
____ I am an undergraduate student who has earned university credit or was awarded credit through AP, IB, CLEP or Cambridge. I have submitted the Prior Credit and Repeat Course Acknowledgement form available at
www.registrar.ufl.edu/va/VAPriorCredit.pdf and will submit unofficial transcripts from ALL post-secondary institutions attended.
Office of the University Registrar, PO Box 114000, 222 Criser Hall, Gainesville, FL 32611-4000, 352-392-1374, ext. 7013, FAX 352-846-2872
Veterans Affairs/VA Enrollment Cert-ALL Chapters.Indd
Rev. 4/11
PAGE 2 Veteran/Dependent Enrollment
Certification Request – All Chapters
Name: ______________________________________________ UFID: _______________________________________
SECTION C: Certification Request
Below is a list of terms for the current certification period. Please indicate number of hours for each term.
Sum A 2011 ___ Hrs Sum B 2011 ___ Hrs Sum C 2011 ___ Hrs Fall 2011 ___ Hrs. Spr 2012 ___ Hrs
SECTION D: Rules and Regulations
As a recipient of VA educational benefits, the University of Florida Veterans Office would like to inform you of the VA rules
and regulations that may apply to you. It is your responsibility to understand and abide by them. Educational benefits are
paid based on registration and specific grade criteria. Please initial each statement.
_____ All official University E-mail correspondence will be sent to my UFL.EDU account.
_____ I understand the VA will no longer issue break pay starting August 1, 2011.
_____ It is my responsibility to pay my tuition and fees, for each term, by the published university deadline, the deferred payment deadline OR upon receipt of VA educational benefits and/or financial aid. Future term registrations could be impacted by failure to pay fees or other financial obligations in a timely manner.
_____ I understand that changes in course enrollment, or an entire term withdrawal, after the last day of the drop/add
period my result in retroactive loss of benefits unless the VA finds that mitigating circumstances are involved in the change. Loss or reduction of benefits could revert back to the first day of the term.
_____ I understand I will not be paid by the VA for courses for which I have already received credit unless the minimum acceptable grade was not achieved and I must retake the course to graduate. If I have to retake a required course, I will obtain a memo from my adviser indicating the course is required. Without this documentation, I understand I will not receive appropriate educational benefits for the course.
_____ I will ensure that all courses are required for my degree program and that I will make satisfactory progress toward graduation. Grades such as I, l*, U, N*, and NG may reduce benefits.
_____ I will not exceed the minimum number of credits required for graduation.
_____ I am required to meet the minimum cumulative UF grade point average (GPA) for my academic program (2.00 for undergraduate/professional and 3.00 for graduate).
a) First term below minimum standard – student is contacted by UF Veterans Office and will receive written notification.
b) Second term below minimum standard – VA is notified of unsatisfactory progress, student is contacted in writing and benefits WILL be terminated until student’s UF cumulative grade point average meets the minimum standard.
_____ If I am a graduate student, I understand that I can be certified for undergraduate courses (numbered 1000-4000) when those courses are REQUIRED for my graduate degree program.
SECTION E – Select ONLY One Category
Post 9/11 (Chapter 33) Recipients ONLY
_____ For Summer 2011 benefits, I understand I am not eligible for Basic Allowance for Housing (BAH) and/or the book stipend while on Active Duty.
_____ For Fall 2011 and future terms, I understand I am not eligible for the BAH while on Active Duty.
_____ Effective Fall 2011, I must be enrolled full-time in my program in order to receive 100% BAH.
_____ I will report ALL additional funding, including scholarships, Graduate Waivers, and third party payments, that is designated for tuition only to the UF VA Office.
Chapters 30, 1606 or 1607 recipients ONLY
_____ In order to maintain my benefit eligibility, I must verify my enrollment at the end of each month of the semester by calling 1(877) 828-2378 OR online at www.gibill.va.gov/wave
SECTION F: Comments or Special Instructions
SECTION G: Signature
I have read the rules and regulations regarding VA benefits at the University of Florida and agree to abide by those policies.
University of Florida guidelines are available at www.registrar.ufl.edu/va. Current federal VA regulations are available at
www.gibill.va.gov.
________________________________________________________
Signature
_______________________
Date
Office of the University Registrar, PO Box 114000, 222 Criser Hall, Gainesville, FL 32611-4000, 352-392-1374, ext. 7013, FAX 352-846-2872
Veterans Affairs/VA Enrollment Cert-ALL Chapters.Indd
Rev. 4/11