{"id":133,"date":"2023-06-06T23:59:08","date_gmt":"2023-06-06T23:59:08","guid":{"rendered":"https:\/\/ct-prod-wp.taftcollege.edu\/forms\/?page_id=133"},"modified":"2024-04-23T09:19:59","modified_gmt":"2024-04-23T16:19:59","slug":"va-online-request-for-certification","status":"publish","type":"page","link":"https:\/\/ct-prod-wp.taftcollege.edu\/forms\/admissions\/veterans-services\/va-online-request-for-certification\/","title":{"rendered":"VA \u2013 Online Request for Certification"},"content":{"rendered":"<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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id=\"input_20e6ca9b186b110388f16192150352d6\" class=\"gfield_recaptcha_response\" type=\"hidden\" name=\"input_20e6ca9b186b110388f16192150352d6\" value=\"\"\/><\/div>\n                        <div class='gform-body gform_body'><div id='gform_fields_30' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_30_34\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_34'>LinkedIn<\/label><div class='ginput_container'><input name='input_34' id='input_30_34' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_30_34'>This field is for validation purposes and should be left unchanged.<\/div><\/div><fieldset id=\"field_30_31\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-seven-twelfths gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Term<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_31'>\n\t\t\t<div class='gchoice gchoice_30_31_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='Summer'  id='choice_30_31_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_30_31\"   \/>\n\t\t\t\t\t<label for='choice_30_31_0' id='label_30_31_0' class='gform-field-label gform-field-label--type-inline'>Summer<span class=\"radio-button\" role=\"none\">\n\t\t\t\t\t<span class=\"radio-button__center\"><\/span>\n\t\t\t\t<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_30_31_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='Spring'  id='choice_30_31_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_31_1' id='label_30_31_1' class='gform-field-label gform-field-label--type-inline'>Spring<span class=\"radio-button\" role=\"none\">\n\t\t\t\t\t<span class=\"radio-button__center\"><\/span>\n\t\t\t\t<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_30_31_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='Fall'  id='choice_30_31_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_31_2' id='label_30_31_2' class='gform-field-label gform-field-label--type-inline'>Fall<span class=\"radio-button\" role=\"none\">\n\t\t\t\t\t<span class=\"radio-button__center\"><\/span>\n\t\t\t\t<\/span><\/label>\n\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_30_31'>Select a term<\/div><\/fieldset><div id=\"field_30_33\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-five-twelfths gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_33'>Year<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_33' id='input_30_33' type='text' value='' class='large'  aria-describedby=\"gfield_description_30_33\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_30_33'>Example: 2025<\/div><\/div><div id=\"field_30_2\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_30_2'>Term of Certification<\/label><div class='ginput_container ginput_container_select'><select name='input_2' id='input_30_2' class='medium gfield_select'  aria-describedby=\"gfield_description_30_2\"   aria-invalid=\"false\" ><option value='Spring 2025' >Spring 2025<\/option><option value='Fall 2024' >Fall 2024<\/option><option value='Summer 2024' >Summer 2024<\/option><\/select><\/div><div class='gfield_description' id='gfield_description_30_2'>Please Select a Term.<\/div><\/div><fieldset id=\"field_30_23\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Guest Student<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_23'>\n\t\t\t<div class='gchoice gchoice_30_23_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='No' checked='checked' id='choice_30_23_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_30_23\"   \/>\n\t\t\t\t\t<label for='choice_30_23_0' id='label_30_23_0' class='gform-field-label gform-field-label--type-inline'>No<span class=\"radio-button\" role=\"none\">\n\t\t\t\t\t<span class=\"radio-button__center\"><\/span>\n\t\t\t\t<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_30_23_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='Yes'  id='choice_30_23_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_23_1' id='label_30_23_1' class='gform-field-label gform-field-label--type-inline'>Yes<span class=\"radio-button\" role=\"none\">\n\t\t\t\t\t<span class=\"radio-button__center\"><\/span>\n\t\t\t\t<\/span><\/label>\n\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_30_23'>Select &#8220;Yes&#8221; if you are a guest student.<\/div><\/fieldset><div id=\"field_30_4\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_4'>Home Campus<\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_30_4' type='text' value='' class='medium'  aria-describedby=\"gfield_description_30_4\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_30_4'>Please tell us which campus you&#8217;re from.<\/div><\/div><fieldset id=\"field_30_5\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_30_5'>\n                            \n                            <span id='input_30_5_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_5.3' id='input_30_5_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_30_5_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_30_5_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_5.6' id='input_30_5_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_30_5_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><div class='gfield_description' id='gfield_description_30_5'>Enter both your first and last name.<\/div><\/fieldset><div id=\"field_30_6\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_6'>Student ID.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_6' id='input_30_6' type='text' value='' class='medium'  aria-describedby=\"gfield_description_30_6\"  placeholder='AXXXXXXX' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_30_6'>Please enter your student ID. If you do not have a student ID please contact the<a href=\"http:\/\/www.taftcollege.edu\/admissions\/veterans\/\">Admissions Office<\/a><\/div><\/div><div id=\"field_30_29\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_29'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_29' id='input_30_29' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_30_7\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-third gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_7'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_7' id='input_30_7' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_30_7\"  \/><\/div><div class='gfield_description' id='gfield_description_30_7'>Please enter your phone number.<\/div><\/div><div id=\"field_30_9\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_9'>VA Chapter Code<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_9' id='input_30_9' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Chapter 30 \u2013 Montgomery Active' >Chapter 30 \u2013 Montgomery Active<\/option><option value='Chapter 31 - Vocational Rehab' >Chapter 31 &#8211; Vocational Rehab<\/option><option value='Chapter 33 - Post 9\/11' >Chapter 33 &#8211; Post 9\/11<\/option><option value='Chapter 35 - Survivors\/Dependents' >Chapter 35 &#8211; Survivors\/Dependents<\/option><option value='Chapter 1606 Select Reserve' >Chapter 1606 Select Reserve<\/option><\/select><\/div><\/div><fieldset id=\"field_30_10\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is this a new major?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_10'>\n\t\t\t<div class='gchoice gchoice_30_10_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='No' checked='checked' id='choice_30_10_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_30_10\"   \/>\n\t\t\t\t\t<label for='choice_30_10_0' id='label_30_10_0' class='gform-field-label gform-field-label--type-inline'>No<span class=\"radio-button\" role=\"none\">\n\t\t\t\t\t<span class=\"radio-button__center\"><\/span>\n\t\t\t\t<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_30_10_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='Yes'  id='choice_30_10_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_10_1' id='label_30_10_1' class='gform-field-label gform-field-label--type-inline'>Yes<span class=\"radio-button\" role=\"none\">\n\t\t\t\t\t<span class=\"radio-button__center\"><\/span>\n\t\t\t\t<\/span><\/label>\n\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_30_10'>Select Yes, if this is a new major.<\/div><\/fieldset><div id=\"field_30_16\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Course Data<\/h3><div class='gsection_description' id='gfield_description_30_16'>Add one or more courses.<\/div><\/div><div id=\"field_30_30\" class=\"gfield gfield--type-form gfield--input-type-form gform-theme__no-reset--children field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_30'>Courses<\/label><div class=\"gpnf-nested-entries-container ginput_container\">\n\n\t<table class=\"gpnf-nested-entries\">\n\n\t\t<thead>\n\t\t<tr>\n\t\t\t\t\t\t\t<th scope=\"col\" class=\"gpnf-field-1\">\n\t\t\t\t\tCourse Name\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th scope=\"col\" class=\"gpnf-field-2\">\n\t\t\t\t\tCourse Number\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th scope=\"col\" class=\"gpnf-field-3\">\n\t\t\t\t\tUnits\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th scope=\"col\" class=\"gpnf-field-4\">\n\t\t\t\t\tStart Date\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th scope=\"col\" class=\"gpnf-field-5\">\n\t\t\t\t\tEnd Date\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th scope=\"col\" class=\"gpnf-field-6\">\n\t\t\t\t\tAdd\/Drop\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th scope=\"col\" class=\"gpnf-field-7\">\n\t\t\t\t\tClass Type\t\t\t\t<\/th>\n\t\t\t\t\t\t<th scope=\"col\" class=\"gpnf-row-actions\"><span class=\"screen-reader-text\">Actions<\/span><\/th>\n\t\t<\/tr>\n\t\t<\/thead>\n\n\t\t<tbody data-bind=\"visible: entries().length, foreach: entries\">\n\t\t<tr data-bind=\"attr: { 'data-entryid': id }\">\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f1.label, attr: { 'data-value': f1.label }\"\n\t\t\t\t\tdata-heading=\"Course Name\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f2.label, attr: { 'data-value': f2.label }\"\n\t\t\t\t\tdata-heading=\"Course Number\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f3.label, attr: { 'data-value': f3.label }\"\n\t\t\t\t\tdata-heading=\"Units\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f4.label, attr: { 'data-value': f4.label }\"\n\t\t\t\t\tdata-heading=\"Start Date\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f5.label, attr: { 'data-value': f5.label }\"\n\t\t\t\t\tdata-heading=\"End Date\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f6.label, attr: { 'data-value': f6.label }\"\n\t\t\t\t\tdata-heading=\"Add\/Drop\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f7.label, attr: { 'data-value': f7.label }\"\n\t\t\t\t\tdata-heading=\"Class Type\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t<td class=\"gpnf-row-actions\" style=\"display: none;\" data-bind=\"visible: true\">\n\t\t\t\t<ul>\n\t\t\t\t\t<li class=\"edit\"><button type=\"button\" class=\"edit-button gform-theme-button--secondary\" data-bind=\"click: $parent.editEntry, attr: { 'aria-label': 'Edit Course {0} where Course Name is {1}.'.gformFormat( $index() + 1, f1.label ) }\">Edit<\/button><\/li>\n\t\t\t\t\t\t\t\t\t\t<li class=\"delete\"><button type=\"button\" class=\"delete-button gform-theme-button--simple gform-theme-button--size-md\" data-bind=\"click: $parent.deleteEntry, attr: { 'aria-label': 'Delete Course {0} where Course Name is {1}.'.gformFormat( $index() + 1, f1.label ) }\">Delete<\/button><\/li>\n\t\t\t\t<\/ul>\n\t\t\t<\/td>\n\t\t<\/tr>\n\t\t<\/tbody>\n\n\t\t<tbody data-bind=\"visible: entries().length <= 0\">\n\t\t<tr class=\"gpnf-no-entries\" data-bind=\"visible: entries().length <= 0\" style=\"display: none;\">\n\t\t\t<td colspan=\"8\">\n\t\t\t\tThere are no <span>Courses.<\/span>\t\t\t<\/td>\n\t\t<\/tr>\n\t\t<\/tbody>\n\n\t<\/table>\n\n\t<button type=\"button\" class=\"gpnf-add-entry\"\n\t\t        data-formid=\"30\"\n\t\t        data-nestedformid=\"31\"\n\t\t\t\tdata-bind=\"attr: { disabled: isMaxed }, css: { 'gf-default-disabled': isMaxed }\"\n\t\t\t\t>\n\t\t\t\tAdd Course\n\t\t\t<\/button>\t\n\t\t\t<p class=\"gpnf-add-entry-max\" data-bind=\"visible: isMaxed\" style=\"display: none;\">\n\t\t\t\tMaximum number of courses reached.\n\t\t\t<\/p>\n<\/div>\n<input type=\"hidden\"\n                name=\"input_30\"\n                id=\"input_30_30\"\n                data-bind=\"value: entryIds\"\n                value=\"\" \/><div class='gfield_description' id='gfield_description_30_30'>Add one or more Courses.<\/div><\/div><div id=\"field_30_25\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Comments and Agreement.<\/h3><\/div><div id=\"field_30_21\" class=\"gfield gfield--type-textarea gfield--input-type-textarea cucomment field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_30_21'>Comments<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_21' id='input_30_21' class='textarea medium'  aria-describedby=\"gfield_description_30_21\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><div class='gfield_description' id='gfield_description_30_21'>If you have any comments please enter them above.<\/div><\/div><fieldset id=\"field_30_22\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Agree to Terms<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_30_22'><div class='gchoice gchoice_30_22_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.1' type='checkbox'  value='Agree'  id='choice_30_22_1'   aria-describedby=\"gfield_description_30_22\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_30_22_1' id='label_30_22_1' class='gform-field-label gform-field-label--type-inline'>Agree<span class=\"checkbox\" 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