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Veteran Certification Request

By submitting this form, I understand the following:

  • All coursework must be required for my approved degree in order to receive VA benefits
  • I must notify the Veterans Certifying Official of any changes in my enrollment for this semester and that such changes could impact my level of educational benefits including potential repayment of benefits (tuition, monthly payment, etc.)
  • I can only be paid for repeated courses when the initial grade received was an ‘F’; VA will not pay for repeats of courses satisfactorily completed unless the course requires a higher grade to progress.
  • No payment can be received for audited courses
  • I consent to the release to the US Department of Veterans Affairs all of my student education records maintained by Moraine Park Technical College, including but not limited to my Social Security Number
  • Chapters 30, 1606 and 1607 recipients must verify enrollment monthly (online via WAVE or by phone)
  • All students are required to maintain an overall grade point average of 2.0 (“C” average). Unsatisfactory progress will be reported to the VA according to the statements in the Moraine Park Student Handbook under Veteran Standards of Progress and Academic Standards. A veteran’s educational benefits will be terminated due to nonattendance or nonparticipation in classes. In the case of any failing grade, the instructor will be contacted to verify the last date of attendance
  • I must complete this form each and every semester in which I wish to be certified for VA educational benefits
  • Identification

  • MM slash DD slash YYYY
  • VA Education Benefit Information

  • Term of Enrollment

  • This field is for validation purposes and should be left unchanged.