VA Request for Certification
TERM/YEAR: FallSpringSummer / 20202021202220232024
STUDENT IDENTIFYING INFORMATION
PROGRAM NAME & MAJOR
VETERAN BENEFIT INFORMATION
I am claiming the following benefit: (Select One)
Are you currently on Active Duty? NoYes
Completion of this form authorizes the Cleary University Records Department to certify my enrollment and provide academic record information to the Department of Veterans Affairs to initiate processing of educational training benefits. I understand that I must complete this form EACH SEMESTER before my enrollment will be certified, and that submission of the certification does not guarantee payment of benefits. It is my responsibility to notify the Records Department immediately upon adding, dropping or withdrawing from a course, and I understand that the Records Department will also report and changes to my enrollment status.
I HAVE READ AND UNDERSTAND THE ABOVE POLICIES AND PROCEDURES.
Leave this empty:
Your legal name
Your email address
If you have questions about the contents of this document, you can email the document owner.
Document Name: VA Request for Certification
Agree & Sign