Veterans Enrollment Certification Request Form

  • Student must notify the School Certifying Official when they want to use their GI Bill benefits. Students can use this form, or complete the paper version in our office.

    All fields are required unless noted otherwise.






    Mailing Address





    Student Type

    Note: Change in enrollment will affect your benefits. Contact the MRC before making any change.


    Select the type of benefits you are using:

    (For all others, please enter "N/A")

    Are you currently on Active Duty?
    Are you Receiving Military Train Assistance (FTA)?
    Are you on Academic Suspension?


    How many credits are you registered for during the upcoming semester?



    Important! Are you taking any classes or training (clinical, student teaching, internship, etc.) at a physical location outside of IUP (Indiana Campus)?



    By my signature below, I hereby affirm the following statement and agree to the following condition:

    • I have read, review, and understand all the Federal Regulations and requirements to the VA education chapter in which I have elected to utilize (
    • Not repeat any course previously taken or completed except as permitted by VA regulations
    • Notify the MRC/ Veteran Affairs Office if I make any changes to my enrollment
    • Understand that classes that are repeated, appears as open electives, or do not apply to my degree, will not be certified as hours toward the VA stipend benefit, and I will be responsible for paying for those classes
    • Check my class schedule to ensure that I am receiving housing benefits (Chapter 33 or 31)
    • Understand it may take the VA up to 8 weeks to process my claim, not turning in proper documentation, failing to report changes to enrollment, or providing incomplete or false information could lead to discontinuation of my benefits and may result in an overpayment.

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