VA Certification Request Form - 2025FA
Financial Aid Office | 309.341.5321 | vets@sandburg.edu
Name
*
First Name
Middle Name
Last Name
Student ID
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com (use an email you monitor regularly)
Please Check One of the Following:
*
I am enrolled and want to be certified for veteran's benefits for this term. (Select your program(s) below)
I plan to enroll later and want to certified for veteran's benefits for this term. (Select your program(s) below)
I am enrolled but DO NOT want to be certified for veteran's benefits for this term.
Have you previously used benefits at Sandburg or another institution?
*
Yes at Sandburg
Yes at another institution
No
I qualify for veterans education benefits based on
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My own military service
My parent's military service
My spouse's military service
How many credit hours are you registering for this semester?
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12 or more
9-11
6-8
5 or less
Federal VA Benefits Programs
State Veterans Benefits Programs
I am a new student or I have changed my program of study:
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Yes
No
Veteran's VA File # (9 digit SSN)
Information will be encrypted upon submission.
Student SSN #
Information will be encrypted upon submission.
Qualifying Veteran's Name
First Name
Last Name
Upload your certificate of eligibility from the VA if you have not yet done so
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We cannot certify any military or veterans benefits without you first applying through the VA or Illinois VA and then submitting a letter of approval to our office.
Cancel
of
Upload a copy of your DD214
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We cannot certify any military or veterans benefits without you first applying through the VA or Illinois VA and then submitting a letter of approval to our office.
Cancel
of
Check this to indicate that you have read and understand the following:
*
I understand that I will only be certified for courses that are required by my program of study. I also understand that I am responsible for repayment of Educational Assistance Benefits issued to me for courses that I do not complete. I authorize release of my school records to the VA in order to comply with required reporting and certification. All Carl Sandburg students receiving financial assistance through the VA must satisfy the requirements of the college's Satisfactory Progress for Veterans, maintaining a cumulative 2.0 GPA on a 4.0 scale. Failure to do so may result in ineligibility for benefits.
Signature
*
Date
*
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Day
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