Veteran Certification Office
One UTSA Circle, San Antonio, TX 78249-0608
210-458-4540 | [email protected] | http://utsa.edu/va/
CERTIFICATION REQUEST
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Submit
ALL STUDENTS utilizing Veterans Educational benefits MUST complete this form each semester AFTER registering for classes. You should
register as soon as possible and complete this certification request.
• I am eligible to receive VA Educational Benefits and request courses applicable to my degree be certified.
• I am not repeating any courses previously taken and completed except as permitted by VA regulation.
• I will notify the UTSA Veteran Certification Office of any changes to my enrollment, address, status or major.
• Certifications for active duty or students below half-time cannot be sent to the VARO until the first day of classes.
• I assume full responsibility for reimbursement of funds to UTSA or the VA should an over-payment occur as a result of this certification.
• Chapter 31 --NOTE** If you are requesting certification within two weeks of the payment deadline or after (for any semester)
you must make payment arrangements (tuition loan or financial aid) until your enrollment is certified. Also, you must make
sure your bill has been cleared (check your ASAP account) or your classes may be dropped. You must also comply with the
book/supply voucher restrictions.
• Chapter 33 --NOTE** If you are requesting certification within two weeks of the payment deadline (for any semester) or after,
you must make payment arrangements (tuition loan or financial aid) until the VA pays your tuition.
• ALL Chapters --NOTE** After initial certification for the semester requested has been done, any changes to your schedule will
be processed after the census date.
MI:
First Name:
Last Name:
Street Address:
Apt #:
Zip:
State:
City:
Minor:
Major (Degree or Program):
Phone Number 2:
Phone Number 1:
myUTSA ID:
Are you working on a:
Preferred Email Address:
Bachelors Degree
Graduate Degree (Master's or PhD)
Certificate Program (Paralegal or CFP)
Which Chapter are you? (check one)
33- Post 9/11
1606- Reserves
30- GI Bill
1607- REAP
31- Vocational Rehabilitation - Do you have DV/Purple Heart plates?
Yes
Answer the following questions for the semester you are certifying for:
Are you on active duty?
Yes
No
Are you on tuition specific scholarships or using TA?
(Note: If yes, any tuition specific funding must be deducted from
your tuition and fees for the semester.)
If so, how much are you receiving?
(Note: Enter 0 if you answered "No")
Are you using the Hazelwood Act?
Yes
No
Yes
No
35- Dependent - File #
No
Spring
Fall
Summer
Are you on Academic Fresh Start?
Yes
No
Are you graduating this semester?
Yes
No
Are you repeating a course for which
you already have received credit?
Yes
No
Course Name:
Note: Please see our website concerning
repeated course information.
Remarks:
I CERTIFY I have read and understand my responsibilities and agree to comply with the above.
Signature*:
(please type in full name)
Date
*Electronic signature - by signing and submitting this form electronically you are requesting certification for the terms selected.
With a few exceptions, you are entitled on your request to be informed about the information U.T. San Antonio collects about you. Under Sections 552.021 and 552.023 of the Texas
Government Code, you are entitled to receive and review this information. Under Section 559.004 of the Texas Government Code, you are entitled to have U.T. San Antonio correct
information about you that is held by us and that is incorrect, in accordance with the procedures set forth in the University of Texas System Business Procedures Memorandum 32.
* Disclosure of your social security number (SSN) is requested from you in order for The University of Texas at San Antonio to access your student records. No statute or other authority
requires that you disclose your SSN for that purpose. Failure to provide your SSN, however, may result in a delay in accessing your student record. Further disclosure of your SSN is
governed by the Public Information Act (Chapter 552 of the Texas Government Code) and other applicable law.