, Post 9/11 GI Bill® , , For questions, please contact: Veteran Services Phone: (253) 833-9111, Extension 2466 Email: [email protected] Quarterly Enrollment Request Due as soon as possible after registering for classes. Attach your class schedule & expanded degree audit. Please fill out in ink. Once complete, please submit this packet to Career & Advising or your faculty advisor for review. Veteran Services will receive the packet once it is signed by an advisor. Name: Student ID: Green River Email: Phone Number: Program of Study: , VA Education Benefit Chapter (Please select one): Post 9/11 , , GI Bill® Transfer , , Post 9/11 GI Bill® Fry Scholarship CH 1606 MGIB Select Reserve CH 31 Voc Rehab , , , , , Quarter: (Please select one): Summer Fall Winter Spring Academic year: 20 _____ Official Use: Hold Placed □ Instructions: Please list all classes you would like the VA to certify to include waitlisted classes. We cannot certify waitlisted classes until you are registered for the classes. Please notify Veteran Services once you have been registered for each waitlisted class. *Please read the back page for information regarding the campus location column. Course ID (i.e. ENGL&101) Item Number *Campus Location: MAIN, AC, KC, ENM, MTC Section Number Credit Number Type of Class (Please Select One): Per VA rules, remedial (below 100 level) classes that are online or hybrid cannot be certified for benefits. Official Use: ADVISOR, Please select: class required for graduation? Lecture Online Hybrid Yes No Yes No Yes No Yes No Yes No Yes No STUDENT - Please read and initial each line: _____; This packet is only used for certification purposes. It is still my responsibility to consult with an academic advisor if I have questions regarding class selection, my Degree Audit, and/or graduation requirements. _____; I understand that the VA will only pay for courses that are REQUIRED for graduation from my program of study at Green River College. Initialing this block acknowledges that I have reviewed my Degree Audit prior to submitting this packet to an academic advisor. _____; If you are certified for classes that are found to be unnecessary due to previously earned credits from another institution, the VA requires that your certification be reduced. You will be in overpayment status with the VA and will owe back any funding you are no longer entitled to have. _____; I understand that if I want the VA to pay for my education, then I must provide Veteran Services with my Quarterly Enrollment Request EVERY QUARTER by submitting this form to an academic advisor in addition to my Quarterly Schedule and Degree Audit. _____; I understand that if I make any changes to my schedule, I must notify Veteran Services as soon as possible and the adjustment to my certification will not be processed until after the 10th day of the quarter (at the earliest). _____; By signing this form, I understand that I am officially requesting to use my VA education benefits for this quarter. _____; For Chapter 33, 33 Transfer, and 33 Fry only: A hold will not be placed on my tuition and fees if I do not have a Certificate of Eligibility or Statement of Benefits on file and have not submitted this form, my quarterly schedule, and degree audit. _____; For Chapter 33, 33 Transfer, and 33 Fry only: Online and hybrid classes are considered “Distance Learning” for VA purposes. If I want the full amount of housing allowance that I am entitled to have, I must be certified as full-time and have at least one “Lecture” (in-residence) class that is required for my degree. Please read the back page regarding hybrid course policy. Student Signature: Date: ADVISOR—Please read and sign: I have reviewed the courses listed and have indicated whether they are or are not required for graduation from the program of study listed on this form. Advisor Signature: Date: Advisor Printed Name: Green River College does not discriminate on the basis of race, creed, color, national origin, sex, sexual orientation, age, marital status, religion, disability, genetic information or on any other unlawful basis. The college is committed to preventing and stopping discrimination, including harassment of any kind and any associated retaliatory behavior. The following person has been designated to handle inquiries regarding the non-discrimination policies: Vice President of Human Resources, 12401 SE 320th Street, Auburn, WA 98092-3622, (253) 288-3320. To receive this information in an alternate format, please contact Disability Support Services at (253) 833-9111, ext. 2631; TTY (253) 288-3359. Lecture Online Hybrid Lecture Online Hybrid Lecture Online Hybrid Lecture Online Hybrid Lecture Online Hybrid CH 35 Dependents Education Assistance