Veteran Certification Request Form

Student's Full Name*

Student's Phone Number*

Student's Address*

Student's City*

Student's State*

Student's Zip Code*

Student's Email Address*

Student's SBU ID Number

Select the semester for which you are requesting benefits:*

Which SBU campus will you be attending?*

Choose your benefit category
If you are unsure of the benefit category to select, please contact Michael Stonestreet, SBU's VA Certifying Official, at (417) 328-1609 or mstonestreet@SBUniv.edu.

New students (transfer and freshmen) are required to meet with the certifying official before the Department of Veterans Affairs certification can be processed.
Distance Education and Deployed/Activated students should contact Veteran Student Services for assistance.

Your benefit category:*

By checking "yes" on each box below you acknowledge that you are the student listed on this form, are requesting certification for the indicated term, and agree to each of the following items.

I have completed the Department of Veteran's Affairs form 22-1990, 22-1990E or form 22-5490 (Application for VA Educational Benefits) and have/will provide a copy of this application or my Certificate of Eligibility from the Department of Veteran's Affairs, and DD-214 (if applicable) to the Office for Veteran Student Services.

Yes

No

I understand that I must complete a new Veterans Certification Request form before each semester in order to receive educational benefits. We recommend students request certification at least 31 days before the start of the term to help ensure timely processing of a student's request.

Yes

No

I understand I must attend class and make satisfactory academic progress to continue to receive Department of Veterans Affairs education benefits at SBU.

Yes

No

I understand that the Department of Veterans Affairs will not pay for courses repeated with a passing grade.

Yes

No

I understand that if I am deployed or need to withdraw during a semester for other military-related circumstances I must notify the Office for Veteran Student Services (mstonestreet@SBUniv.edu) and supply a copy of my orders for verification.

Yes

No

I understand that adding or dropping a class, enrolling in a class that does not apply to my degree program, or enrolling in classes with various beginning and ending dates such as intersession classes, eight-week block classes and certain summer classes, may affect the monthly dollar amount of educational benefits I receive. (For clarification as to whether you are full-time for certification purposes, we encourage students to contact the Office for Veteran Student Services directly.)

Yes

No

I understand that if I receive Chapter 30, Chapter 33 or Chapter 1606 benefits I must report school attendance to the Department of Veterans Affairs at the end of each month in order to receive payment. I can report by phone (1-877-823-2378) or online (www.gibill.va.gov).

Yes

No

I understand that if I receive Chapter 33 benefits I must be enrolled in at least one "On Campus" course in order to receive the local Basic Housing Allowance (BAH). Students taking only online classes may be eligible for a portion of BAH based on the national online distance learning rate as published by the Department of Veterans Affairs (www.va.gov).

Yes

No

I understand that I have the responsibility to ensure that I have benefit time remaining, and/or will make arrangements for any other tuition/fee related expense not covered by the Department of Veterans Affairs. For questions regarding your eligibility or payment amounts, students should contact the Department of Veteran Affairs at 1-888-442-4551.

Yes

No

I understand that if I use Chapter 31 or Chapter 33 benefits, then I may use a book voucher to obtain my books, but I will be responsible for making sure those funds are repaid in a timely manner.

Yes

No

I understand that if I make changes to my schedule, no matter which benefit I am using, I must notify Michael Stonestreet at mstonestreet@SBUniv.edu of those changes.

Yes

No

For assistance in understanding or complying with the above regulations, please contact the SBU VA Certifying Official, Michael Stonestreet, at (417) 328-1609.

After submitting this form, though most students receive payment much earlier, please allow at least 4-6 weeks for your information to be updated with the Department of Veterans Affairs.

SBU's VA Certifying Official will provide support services throughout your academic pursuits while trying to provide a timely certification. It is important to note that this list is not meant to be an all-inclusive list of responsibilities, and it remains the student's responsibility to ensure that they are in compliance with their respective benefit program. If you have any questions at any time, please contact the SBU VA Certifying Official, Michael Stonestreet, directly at (417) 328-1609 or mstonestreet@SBUniv.edu.

By submitting this form you acknowledge your understanding of the aforementioned responsibilities.

Veteran Certification Request Form

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