Home / Veteran Services / Veteran Services | Veteran Benefit Certification Form Veteran Benefit Certification Form All new students must complete and return the Veterans Responsibilities Form (pdf) before your enrollment can be certified. Asterisk indicates required field. ( * ) Personal InformationName * Required First Last Address * Required Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone * RequiredEmail * Required Student ID * RequiredSocial Security # * RequiredChapterSelect Your ChapterChapter 30 Montgomery G.I. Bill / VRAPChapter 31: Vocational Rehabilitation and Employment (VR&E)Chapter 33 Post 9/11Chapter 35 Survivor's and Dependent Assistance ProgramChapter 1606 Selected ReserveChapter 1607 Reserve Educational Assistance Program (REAP)Are you on active duty?YesNoAre you receiving Federal Tuition Assistance?YesNoVA File #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 StudentNew Student (I have never used my VA Education Benefits and have not attended a College or University)Returning StudentTransfer StudentVisiting StudentReturning Student Additional informationI have never used my VA education benefitsI HAVE used my VA education benefitsTransfer Student Additional InformationI have never used my VA education benefitsI HAVE used my VA education benefitsName of Parent School:ClassesFor which semester are you requesting your enrollment to be certified with the VA? * RequiredFallWinterSpring/SummerYear * RequiredIs this your initial certification for the above semester? * RequiredYesNoIf 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.