Home / Services & Support / Veteran Services / Forms & Resources / Veteran Benefit Certification Form Benefit Certification Form All new students must complete and return the Veterans Responsibilities Form (pdf) before your enrollment can be certified. Personal InformationName * Required First Last Address * Required Street Address Address Line 2 City State / ProvinceAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone * RequiredEmail * Required Student ID * RequiredSocial Security # * RequiredChapterSelect Your Chapter (Need to submit sponsor name and SSN for initial submissions) Chapter 30 Montgomery GI Bill® / VRAP Chapter 31: Vocational Rehabilitation and Employment (VR&E) Chapter 33 Post 9/11 Chapter 33T: Transfer of Entitlement Chapter 35 Survivor’s and Dependent Assistance Program Chapter 1606 Selected Reserve Percentage (%)Sponsor NameYou only need to provide this information if this is the first time you’ve filled out this form. First Last Sponsor Social Security #You only need to provide this information if this is the first time you’ve filled out this form.Are you on active duty? Yes No Are you receiving Federal or State Tuition Assistance? Yes No Are you receiving Federal or State Tuition Assistance? Yes No VA File #Are you utilizing Military Tuition Assistance or MYCAA. Yes No Degree PlanDegree * RequiredIf this is a change in degree from your previous semester, please fill out a Change of Program/Place of Training Form and return it to your VA Certifying Official in order for your enrollment to be certified.Type of Student New Student (I have never used my VA Education Benefits and have not attended a College or University) Returning Student Transfer Student Visiting Student Returning Student Additional information I have never used my VA education benefits I HAVE used my VA education benefits Transfer Student Additional Information I have never used my VA education benefits I HAVE used my VA education benefits Name of Parent School:Are you using a scholarships such as th Tuition Assistance Program, Future for Frontliners, Michigan Reconnect or other funding source that is not the Pell grant? Yes No ClassesFor which semester are you requesting your enrollment to be certified with the VA? * RequiredFallSpringSummerYear * RequiredIs this your initial certification for the above semester? * Required Yes No If no, which of the following changes apply: Change of classes Change of program Student Veterans of America I am interested in the Student Veterans of America group at Jackson College Questions or commentsConfirmationConfirmation 1 * Required I have read, understand, and submitted the VA Responsibility Form. Confirmation 2 * Required I understand that all correspondence will be sent to my JC Email account. Confirmation 3 * Required I confirm that all the information submitted here is accurate. Δ Services & Support Academic Support Academic Advising Catch-Up Workshops Center for Student Success Testing Lab Tutoring & Writing Support Peer Tutoring Faculty Tutoring Supplemental Instruction Writing Center Writing Fellows Career Services Career Assessment Career Preparation Internships Jackets for Jets Online Job Board Food & Personal Support Emergency Support Food Resources Harriet’s Hub Health Support Dental Clinic Health Clinic Oasis Center Library Hours Find Borrow Help Reserve a Room Faculty Resources Specialized Support Accommodations for Students with Disabilities Foster Youth Occupational Support TRIO Student Support Services Student Services Course Management Register for Classes Drop or Withdraw from a Class Grading System Graduation & Commencement Student Forms Student Records Request a Transcript Residency Student ID Cards Update Student Information Student Resolution Advocate Academic Complaint Process Technology Support Veteran Services Education Benefits Course Information Forms & Resources Contact Veteran Services
