EmailMe Form - Request for Certification Form: Old

Student Name *

First Last

Student ID Number *

Student Email Address *

Confirm

What is your status? *

Active Duty

Dependent

Spouse

Veteran

Please share your branch of service.

Please share the branch of service of your spouse.

VA Benefit You Wish to Use *

Have You Applied for a Benefit? *

Yes

No

If you are not sure the benefit you qualify for, please contact the VA by calling 1-888-442-4551 (option 1, option 0).

If you know the benefit you would like to use and have not yet applied, please visit the VA's VONAPP website:http://vabenefits.vba.va.gov/vonapp/ and complete the appropriate form.

Requested Certification Term *

MM / DD / YYYY

Please enter start date.

If you have received your Certification of Eligibility, please attach it.

If you are using Ch. 35, please include the Vet File number with your COE or contact the military services team to provide it directly.

Are you using Tuition Assistance? *

Yes

No

If you plan to use TA, please send TA Authorization form to Sponsorships@waldenu.edu

Are you using Tuition Assistance Top Up? *

Yes

No

Please send TA Authorization to Sponsorships@waldenu.edu and CC:Military@waldenu.edu.

Are you using Chapter 31 benefits?

Yes

No

Please attach your Chapter 31 1905 or have your Vocational Rehabilitation counselor send the form to military@waldenu.edu.

Student Responsibilities

Please thoroughly read and complete the student responsibilities portion of this form.

As always if you should have any questions or if our team can provide further support, please do not hesitate to contact us at military@waldenu.edu.

Enrolling in courses which are not listed on my degree plan will affect my ability to be certified. Changing my major will require a communication with my Military Services representative. *

I have read this statement.

If I want to receive benefits retroactive up to a year, I must notify the Military Services representative. I understand if I choose this option it will count against my months of available entitlement. *

I have read this statement.

I understand that it is my responsibility to inform Walden if I wish to partake in the military tuition discount offering. I agree to submit my DD214, LES, or COE for processing to billing@waldenu.edu if I choose to participate. *

I have read this statement.

I will be certified for GI Bill benefits for only those courses applicable to my academic program. It is my responsibility to review my “Degree Plan” or meet with an academic advisor when planning my schedule to ensure my courses meet these requirements. *

I have read this statement.

I understand I should register for classes as early as possible to ensure I am certified in time for classes. Late registration may cause a delay in timely processing from the VA. *

I have read this statement.

I will not be certified for GI Bill benefits for a repeat of any course previously passed that meets graduation requirements at Walden University. *

I have read this statement.

I must meet the Satisfactory Academic Progress Policy in order to remain eligible for veterans’ benefits. Failure to comply with this requirement will result in the removal of all veterans’ educational benefits and I will be responsible for charges on my account. This policy is available in the Academic Catalog. *

I have read this statement.

I understand that if I am not planning to attend Walden University, it is my responsibility to officially withdraw from my course(s) through my student portal. It is not the school’s responsibility to drop me from my courses. *

I have read this statement.

I am aware that any changes to my enrollment may affect my veterans’ educational benefits resulting in an overpayment notice from the VA. *

I have read this statement.

I am aware that if I withdraw from my course(s) after the drop deadline, and receive a non-punitive (W) grade, I may be required to make partial or complete repayment of my GI Bill educational benefits for the term. If I completely withdraw from school or receive a F due to non-attendance I may be required to repay a portion or all of my educational benefit. *

I have read this statement.

I am financially liable for all charges related to my registration and understand that I am responsible for payment of all tuition and fees not covered by my veterans’ educational benefits. *

I have read this statement.

I understand that if I am utilizing Chapters 30, Chapter 1606 or Chapter 35 – Survivors and Dependents benefits, I am responsible for tuition and fees due by the payment due date. A monthly stipend is paid to the student by the VA the first of the month following attendance of courses. *

I have read this statement.

I understand that the Post 9/11 GI Bill will pay tuition directly to the institution based on my percentage of eligibility. I am responsible for any unpaid balance by the payment due date. *

I have read this statement.

I understand that enrolling in less than 6 credits in a term, for graduate level courses, will effect my BAH while utilizing Post 9/11. *

I have read this statement.

By submitting this form I am certifying that I have read and understood the above conditions. *

Please enter your name.