Please fill out the enrollment certification request form once you have completed your scheduling of classes. Required fields are indicated with a * symbol. Thank you!

* First Name

* Last Name

* Student ID#

* Phone Number

Area Code

Prefix

Suffix

Extension

* Email

* Educational Benefit

Select a Value Chapter 30 - Active Duty (MGIB-AD) Chapter 31 - Vocational Rehabilitation Chapter 33 - Post 9/11 GI Bill Chapter 35 - Dependents' Educational Assistance (DEA) Chapter 1606 - Selected Reserve (MGIB-SR) VRRAP - Veterans Retraining Assistance Program

* Requesting Enrollment Certification for:

Select a Value Fall 2021 Spring 2022 Summer 2022 Fall 2022

* Is this your first time requesting benefits at Augusta Tech?

Yes
No

* Enrollment Certification Type:

Registration Completed
Change Schedule: Adding Classes
Change Schedule: Dropping Classes
Change Schedule: Total Withdrawal

* Program of Study:

* Total Credit Hours/Change Schedule - Adding Credit Hours/Dropping Credit Hours:

If Change Schedule - Total Withdrawal selected, Please provide reason for Withdrawal:

* Student Obligation and Responsibilities (read and select all):

1. Benefits will only pay for classes within my approved program of study and I will be responsible for any remaining balances incurred by unapproved actions.
2. If I change my personal information; class schedule; program of study; do not attend throughout the entire semester; or drop a course at any time during the term; I must notify the VA Certifying Official with a new enrollment certification (I may be liable for any overpayments to the school from the VA).
3. Certifications are processed at a first come first serve basis and can be submitted up to 120 days prior to the term. My certification can take up to 30 days to process at the VA once Augusta Technical College certifies me.
4. I should submit all required documents to complete my certification as early as possible to the Military Service Center Representative in order to receive my benefits on time.
5. I understand that if I am not eligible for 100% Post 9/11 or if my benefits are paid directly to me I am responsible for paying my remaining balance prior to the term. If I fail to meet the payment deadline I understand that I will be withdrawn from my classes.

* Student Confirmation (required):

I have read and understand the Student Obligation and Responsibilities and requirement to do an Enrollment Certification every term.

Comments?

Upload Certificate of Eligibility

Browse... Filename(s)

Security Check
letters are case-sensitive

Submit