VETERANS RECERTIFICATION WORKSHEET

Required

1801 N Cottonwood Iola, KS 66749
Phone: 620.365.5116 ext.6291
Fax: 620.365.7403

Namerequired

First Name

Last Name

Email Addressrequired

Phone Numberrequired

Address 1required

Address 2

Cityrequired

Staterequired

Ziprequired

Please select which benefit you plan to use:required

CHPT 30 M Montgomery GI Bill (MGIB)

CHPT 33 Post 9/11 GI Bill

CHPT 1606 MGIB for Select Reserve

CHPT 31 Veteran Readiness & Employment (VR&A)

CHPT 35 Dependent's Education Assistance (DEA)

Unknown

What Semester do you plan to enroll at Allen in?required

Of what year?required

What do you request to be certified to the VA as?required

Allen Degree/Certificate Student

Guest Student

Please list Program Degree/Certificaterequired

Please List Parent Schoolrequired

To be certified, you must request a "PARENT SCHOOL LETTER" be sent to Allen Veterans Services.

Changes to your course schedule OR enrollment in classes outside your current compliance agreement, repeating successfully completed classes, or enrolling in short-term classes, may result in the VA determining an overpayment in your benefit - all overpayments are the responsibility of the benefit recipient.
You must attend class and make satisfactory academic progress as defined in the ACC Student Handbook.
You must submit a Veterans Recertification Worksheet to the ACC Veteran Services office to have subsequent semester enrollments certified to the VA.
Prior credit from all previous colleges, as well as your DD214, must be evaluated and credited toward your degree/certificate requirements.
If you change your ACC degree/certificate intent, you must notify the ACC Veteran Services office and complete a new Compliance Agreement.
The ACC VA Office corresponds via the ACC student email system. It is your responsibility to check your ACC student email account.

Terms of Servicerequired

By submitting this form I state that I have provided accurate information, have read and understand the above statements, and agree to comply with all VA guidelines

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