VA – Online Request for Certification

Admissions – VA Request for Certification

"*" indicates required fields

Term of Certification*

Please Select a Term.

Guest Student

Yes

Select “Yes” if you are a guest student.

Home Campus

Please tell us which campus you’re from.

Name*

First Last

Enter both your first and last name.

Student ID.*

Please enter your student ID. If you do not have a student ID please contact theAdmissions Office

Email*

Phone*

Please enter your phone number.

VA Chapter Code*

Is this a new major?

Yes

Select Yes, if this is a new major.

Course Data

Add one or more courses.

Courses

Course Name	Course Number	Units	Start Date	End Date	Add/Drop	Class Type	Actions

There are no Courses.

Add one or more Courses.

Comments and Agreement.

Comments

If you have any comments please enter them above.

Agree to Terms*

Agree

I certify that:
• I am aware that only courses that are required for my degree objective will be certified.
• I am aware that changes in my course enrollment and length of term of my courses may alter the payment the VA will award me.
• I understand that I will be responsible for any overpayment I might receive for all unreported withdrawls or FW grades.
• I am aware that I must fill out this form each semester after registering for classes.
• I am aware that the certification process may take up to 14 days, so I am responsible for ensuring that I submit this request prior to the term payment deadline.

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