VA Educational Benefits - Notice of Change Form

Students using VA Educational Benefits should submit this form once they are aware of any changes to their current or upcoming semester schedule. Change we are required to report which may have an impact on your benefits include, but are not limited to:

-a change begin date or end date
-a change in tuition and fees
-an increase or decrease in credit hours
-a change in campus or delivery mode (on ground or online)

Submission of this form indicates that a notice of change, or amendment, may need to be made to the student's current certification and the School Certifying Official should review.

Please note, this form cannot be used to withdrawal from a course. You should still submit a Course Withdrawal Form if necessary.

Student Name Student Name First Last
Student ID
Email
Academic semester to be reviewed for amendment:

Academic semester to be reviewed for amendment: Fall Intersession Spring Summer
Year
Does your account currently have a financial hold?

Does your account currently have a financial hold? Yes No
Any changes to your registration may have an impact on your benefits. Due to this, it is important to ensure your schedule is complete before you submit this form and we make any amendments.
Is your registration for the current semester now finalized?

Any changes to your registration may have an impact on your benefits. Due to this, it is important to ensure your schedule is complete before you submit this form and we make any amendments.
Is your registration for the current semester now finalized? Yes No

If you select "Yes", our school certifying official will amend your certification as necessary. If you select "No," someone from the Veteran Services team may be contacting you.
By signing this document, you understand that the School Certifying Official will be submitting an amendment for the corresponding semester's certification with the VA. Please be aware, any schedule changes made after the initial certification may delay payments or monthly housing allowance.
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date of Submission Date of Submission / MM / DD YYYY