View Site Map!
 AWC INDEX
a b c d e f g h i j k l m
n o p q r s t u v w x y z
Military & Veteran Services

Educational Benefit Certification Request

Please complete all requested information.

This request is for the following Semester (Please select one)*   Year 20
PERSONAL INFORMATION
Name*

Last Name


First Name


MI
AWC ID Number*
AWC Login ID (i.e. ber49)*

Street Address*
City*
State*
Zip*
Phone
Are you an Arizona resident
(You may qualify for in-state tuition & fees rates. See the VSO)
Yes No

* These are required fields

STUDENT INFORMATION

Please mark the appropiate information below*

Is this your first time using VA educational benefits?
Is this a revision of a previous request?
Are you transferring from another school?
Are you taking courses from another school?
Do you currently receive any Financial Aid, Scholarships or Awards?
Yes No
Yes No
Yes No
Yes No
Yes No

Degree Sought *

Are you repeating any classes?* Yes No

List AWC classes to be Certified*

Course #Credit hoursOnline course
(Yes/No)
Select One
(Add/Drop)
Example: CIS-100-0013NoAdd
Add course | Delete course

* These are required fields

VETERAN EDUCATION BENEFITS INFORMATION

Which VA Education Benefit Program are you requesting to be certified under this semester? Please visit www.gibill.va.gov to learn which education benefit is best for you:

Benefit Program*

* These are required fields

TERMS AND CONDITIONS

ALL COURSE WORK MUST BE REQUIRED FOR THE DEGREE IN ORDER TO USE VETERANS BENEFITS. FOR ALL FAILING GRADES, THE INSTRUCTOR WILL BE CONTACTED FOR LAST DATE OF ATTENDANCE. NOT ATTENDING CLASSES MAY AFFECT YOUR TOTAL BENEFIT.

Reduction in course enrollment after certification will be submitted to the VA and may result in the retroactive loss of benefits unless the VA finds mitigating circumstances involved in the change. Loss of benefits could revert back to the first day of class.

I AM AWARE THAT CHANGES IN MY REGISTRATION MAY ALTER THE VA PAYMENTS I AM AWARDED.
I UNDERSTAND THAT I WILL BE LIABLE FOR ANY OVERPAYMENT I MIGHT RECEIVE FROM THE VETERANS ADMINISTRATION.
I ALSO UNDERSTAND THAT I MUST NOTIFY THE VA CERTIFYING OFFICIAL AND THE VETERAN AFFAIRS ADMINISTRATION OF ANY CHANGES IN MY REGISTRATION.
I AM AWARE THAT I MUST COMPLETE THIS FORM FOR EACH TERM IN WHICH I WISH TO BE CERTIFIED AFTER I HAVE REGISTERED FOR THAT TERM.
I AM AWARE THAT I AM RESPONSIBLE FOR ANY TUITION/ FEES NOT PAID FOR BY THE VA.

I hereby certify that all statements are true and complete to the best of my knowledge. I give AWC permission to request military transcripts on my behalf.

Future Students | Current Students | Distance Education | Community Partners | AWC Foundation
About AWC | Admissions | Financial Aid | Online Services | Athletics | Student Life | Employment
 © 2014 Arizona Western College Disclaimers | EEOC | Site Map | Comments