Request To Certify Enrollment

Legal First Name

Legal Last Name

Student/LoLA ID Number

Student Social Security Number

Birth Date

MonthDayYear

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Alt. Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

Term you are requesting to certify

Year you are requesting to certify

Ex: 2020

Current Major/Program

Do you receive any of the following aid? Check all that apply.

Have you ever received VA Educational Benefits at SoLAcc?

Are you currently on active duty?

Select the VA education program you will receive benefits under.

Veteran's Full Name

First NameLast Name

What is the Veteran's SSN (VA File Number)?

Are you receiving LA State Fee Exemption?

What is your percentage of eligibility?

Were benefits transferred from a parent or spouse?

Provide the email address of your case manager?

Attach a copy of your schedule. Need help? See instructions below.

List all courses applicable to the semester you wish to certify. Select "+" to add additional courses.

Veteran's Statement of Understanding

Please read and Initial Each Statement

Initial*   I understand that I will need to submit a copy of my Certificate of Eligibility to the SoLAcc Veteran Certifying Official. (Chapter 1606, 30, 33, and 35)

Initial    *   I understand that all official transcripts of prior college work and military schools must be on file and evaluated by the end of the first term of attendance at my primary college.

Initial*   I understand that each term, I will be required to complete a "Request to Certify Enrollment" form and submit a copy of my "Concise Student Schedule" in order to utilize and continue my education benefits.

Initial*   I understand that it is my responsibility to report any changes (Adds/Drops/Withdrawals/Program Changes) to the SoLAcc Veteran Certifying Official. Notification of change(s) must be made by completing the "Enrollment Change for VA Benefits form."

Initial*   I understand that enrolled courses, not a part of my curriculum, will not be certified, and I am responsible for paying tuition for these courses. If it is found that I have enrolled in a course that is not within my program in a VA compliance audit or in the proper modality as stated by the VA, I accept the consequences. I understand that it may potentially lead to a debt owed to the Department of Veteran Affairs or South Louisiana Community College.

Initial*   I understand that any changes in my enrollment (submit Enrollment Change for VA Benefits form) and self- certify with the Department of Veterans Affairs will be reported to VA and may affect my payment amount.

Initial*   I understand that I am responsible for all debts owed to SoLAcc and/or VA resulting from any reduction of my enrollment.

Initial*   I accept the responsibility for monitoring my completed course grades on a checklist as I complete my courses with a passing grade as a means to track my degree progress and to ensure I am taking coursework that is approved for my program. Program curricula are located in the SoLAcc Catalog, which may be accessed on the school's website.

Initial   * I acknowledge that if I receive a grade of FS (Failed Stop) at the end of the semester, the Financial Aid Office will report this status to the Department of Veterans Affairs, as it indicates I stopped attending classes. I understand that my enrollment certification will be adjusted to reflect my last date of attendance. I further understand that this may impact my VA education benefits, including tuition and housing allowances, which could be reduced or may require repayment.

   Initial*   I authorize SoLAcc to certify my enrollment for the above term(s) and release information to VA concerning my academic status.

It is the student's responsibility to contact an advisor prior to registering for courses. Courses that do not apply to the student's program/major will not be certified to the VA. The student will be financially responsible for any course(s) that is not applicable to the student's program.

Today's Date

MonthDayYear

Are all courses applicable towards student's degree?

If "no," specify which course(s) do not apply towards student's degree.