Veterans Benefits and Tuition Assistance Form Date* Name* First Last Semester (ie Fall 2016)*Total Credits for Semester*Educational Objective*AssociateBachelorMasterClassification*FreshmanSophomoreJuniorSeniorGraduate LevelTransferSemester Courses: List your courses and designate if you will be taking them in class or online. In Class includes logging in live for class.*For example: Research and Writing/In Class Biblical Leadership/In Class Theology I/OnlineVeteran, Active Duty, or Dependent*Post 9/11 Chapter 33Montgomery GI Bill (Chapter 30)Vocational Rehabilitation (Chapter 31)Active Duty (Tuition Assistance)Dependent's Educational Assistance (Chapter 35)Dependent Post 9/11 (Chapter 33)Tuition Assistance Form (Active Duty Only)Please upload your TA Form for processing. Drop files here or Obligation to Virginia Baptist College and Veteran Affairs* I understand that I must submit this form each semester for payments and that I must promptly report any changes in my academic program (major, degree, etc.), credit hour changes in enrollment, graduation date, or address to the Military Educational Benefits Coordinator. I understand that before I withdraw from a class I need to inform the Military Education Benefit Coordinator to complete a withdrawal form for my school military record. I understand that I must have all majors, minors and concentrations declared in order for any courses applicable to those programs to be paid for by the VA. For example: if a course is listed for a minor, the minor must be declared or be in the process of being declared before the VA will pay. I understand that the VA determines eligibility for education assistance in all cases. I understand that I must call the VA [(888) 442-4551] or go to www.gibill.va.gov to report my address change. I understand that changes in course enrollment after the drop/add period courses 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 the term and may result in VA debt. I understand that I must be enrolled in an academic degree program (major, minor, etc.) to receive VA benefits. I understand that I can only receive benefits for courses required for my degree and that I must make satisfactory progress toward graduation/completion. I understand that withdrawal from courses and subsequent grades of ‘W’ or‘WF’ will likely result in a student debt with the VA. I understand that the VA will not pay for courses that I audit, take without credit, or do not attend, and that the VA will hold me responsible for any education benefit debt. I understand that advisor error or advisement is not an acceptable reason for taking courses not applicable to my program or withdrawing from a course. I understand that repeating a course may or may not be payable by the VA. I understand that full-time status is different for summer enrollment. I understand that I cannot use both Tuition Assistance and the GI Bill concurrently for the same courses. This may constitute a duplication of benefits which is prohibited by law. I understand that if I am eligible for Chapters 30, 1606 or 1607 (does not apply to Post 9/11 GI Bill) that I am required by the VA to verify my enrollment on the last calendar day of every month in which I attend courses. This can be accomplished by visiting www.gibill.va.gov/wave or by calling their toll free number: (800) 823-2378. Failure to perform this step will result in delayed payment by the VA. I understand that I accept full responsibility for information disclosed on this form. This information is used to certify my enrollment at VBC and to use Military/Veterans Educational Benefits. I understand that if I do not comply with VA guidelines my education benefits may be discontinued and I may be subject to VA debt. I understand that in accordance with FERPA, School Certifying Officials can review and discuss my academic record with Department of Veterans Affairs representatives. Additional Comments This iframe contains the logic required to handle AJAX powered Gravity Forms.