{"id":23446,"date":"2017-03-30T17:19:03","date_gmt":"2017-03-30T17:19:03","guid":{"rendered":"http:\/\/pre-production.taftcollege.edu\/admissions\/?page_id=23446"},"modified":"2019-02-02T12:45:12","modified_gmt":"2019-02-02T12:45:12","slug":"va-online-request-for-certification","status":"publish","type":"page","link":"https:\/\/archive.taftcollege.edu\/admissions\/veterans\/va-forms\/va-online-request-for-certification\/","title":{"rendered":"VA &#8211; Online Request for Certification"},"content":{"rendered":"<section class=\"wpb-content-wrapper\"><p>[vc_row css_animation=&#8221;&#8221; row_type=&#8221;row&#8221; use_row_as_full_screen_section=&#8221;no&#8221; type=&#8221;full_width&#8221; text_align=&#8221;left&#8221;][vc_column][vc_column_text]<\/p>\n<ol>\n<li>Complete this form each semester for which you enroll and want to be paid.<\/li>\n<li>Courses previously completed and passed cannot be re-certified for payment.<\/li>\n<li>It is your responsibility to report class changes or withdrawals to the certifying official and the VA as they occur.<\/li>\n<li>Any classes listed on this form for payment must be degree applicable and listed on your student education plan provided by an Academic Counselor!<\/li>\n<\/ol>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row css_animation=&#8221;&#8221; row_type=&#8221;row&#8221; use_row_as_full_screen_section=&#8221;no&#8221; type=&#8221;full_width&#8221; text_align=&#8221;left&#8221;][vc_column]\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_3' style='display:none'>\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_3'  action='\/admissions\/wp-json\/wp\/v2\/pages\/23446' data-formid='3' novalidate><input id=\"gpnf_session_hash_3\" type=\"hidden\" name=\"gpnf_session_hash\" value=\"40bb0289e7bb\">\n                        <div class='gform-body gform_body'><div id='gform_fields_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_3_2\" class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_2'>Term of Certification<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_2' id='input_3_2' class='medium gfield_select'  aria-describedby=\"gfield_description_3_2\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='Summer 2023' >Summer 2023<\/option><option value='Spring 2023' >Spring 2023<\/option><option value='Fall 2023' >Fall 2023<\/option><\/select><\/div><div class='gfield_description' id='gfield_description_3_2'>Please Select a Term.<\/div><\/div><fieldset id=\"field_3_23\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Guest Student<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3_23'>\n\t\t\t<div class='gchoice gchoice_3_23_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='No' checked='checked' id='choice_3_23_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_3_23\"   \/>\n\t\t\t\t\t<label for='choice_3_23_0' id='label_3_23_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_23_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_23' type='radio' value='Yes'  id='choice_3_23_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_23_1' id='label_3_23_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_3_23'>Select \"Yes\" if you are a guest student.<\/div><\/fieldset><\/fieldset><div id=\"field_3_4\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_4'>Home Campus<\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_3_4' type='text' value='' class='medium'  aria-describedby=\"gfield_description_3_4\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_3_4'>Please tell us which campus you're from.<\/div><\/div><fieldset id=\"field_3_5\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_3_5'>\n                            \n                            <span id='input_3_5_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_5.3' id='input_3_5_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_3_5_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_3_5_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_5.6' id='input_3_5_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_3_5_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><div class='gfield_description' id='gfield_description_3_5'>Enter both your first and last name.<\/div><\/fieldset><\/fieldset><div id=\"field_3_6\" class=\"gfield gfield--type-text gfield--width-third gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_6'>Student ID.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_6' id='input_3_6' type='text' value='' class='medium'  aria-describedby=\"gfield_description_3_6\"  placeholder='AXXXXXXX' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_3_6'>Please enter your student ID. If you do not have a student ID please contact the<a href=\"https:\/\/archive.taftcollege.edu\/admissions\/veterans\/\">Admissions Office<\/a><\/div><\/div><div id=\"field_3_29\" class=\"gfield gfield--type-email gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_29'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_29' id='input_3_29' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_3_7\" class=\"gfield gfield--type-phone gfield--width-third gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_7'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_7' id='input_3_7' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_3_7\"  \/><\/div><div class='gfield_description' id='gfield_description_3_7'>Please enter your phone number.<\/div><\/div><div id=\"field_3_8\" class=\"gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_8'>VA File Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_3_8' type='text' value='' class='medium'  aria-describedby=\"gfield_description_3_8\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_3_8'>(Dependent\/Spouse please list SSN of Veteran)<\/div><\/div><div id=\"field_3_9\" class=\"gfield gfield--type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_9'>VA Chapter Code<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_9' id='input_3_9' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Chapter 30 \u2013 Montgomery Active' >Chapter 30 \u2013 Montgomery Active<\/option><option value='Chapter 31 - Vocational Rehab' >Chapter 31 - Vocational Rehab<\/option><option value='Chapter 32 - VEAP Post Vietnam' >Chapter 32 - VEAP Post Vietnam<\/option><option value='Chapter 33 - Post 9\/11' >Chapter 33 - Post 9\/11<\/option><option value='Chapter 35 - Survivors\/Dependents' >Chapter 35 - Survivors\/Dependents<\/option><option value='Chapter 106 - Montgomery Reserves' >Chapter 106 - Montgomery Reserves<\/option><option value='1067 REAP' >1067 REAP<\/option><\/select><\/div><\/div><fieldset id=\"field_3_10\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is this a new major?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3_10'>\n\t\t\t<div class='gchoice gchoice_3_10_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='No' checked='checked' id='choice_3_10_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_3_10\"   \/>\n\t\t\t\t\t<label for='choice_3_10_0' id='label_3_10_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3_10_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_10' type='radio' value='Yes'  id='choice_3_10_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3_10_1' id='label_3_10_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_3_10'>Select Yes, if this is a new major.<\/div><\/fieldset><\/fieldset><div id=\"field_3_16\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Course Data<\/h3><div class='gsection_description' id='gfield_description_3_16'>Add one or more courses.<\/div><\/div><div id=\"field_3_30\" class=\"gfield gfield--type-form gform-theme__no-reset--children field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_30'>Courses<\/label><div class=\"gpnf-nested-entries-container ginput_container\">\n\n\t<table class=\"gpnf-nested-entries\">\n\n\t\t<thead>\n\t\t<tr>\n\t\t\t\t\t\t\t<th scope=\"col\" class=\"gpnf-field-1\">\n\t\t\t\t\tCourse Name\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th scope=\"col\" class=\"gpnf-field-2\">\n\t\t\t\t\tCourse Number\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th scope=\"col\" class=\"gpnf-field-3\">\n\t\t\t\t\tUnits\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th scope=\"col\" class=\"gpnf-field-4\">\n\t\t\t\t\tStart Date\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th scope=\"col\" class=\"gpnf-field-5\">\n\t\t\t\t\tEnd Date\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th scope=\"col\" class=\"gpnf-field-6\">\n\t\t\t\t\tAdd\/Drop\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th scope=\"col\" class=\"gpnf-field-7\">\n\t\t\t\t\tClass Type\t\t\t\t<\/th>\n\t\t\t\t\t\t<th scope=\"col\" class=\"gpnf-row-actions\"><span class=\"screen-reader-text\">Actions<\/span><\/th>\n\t\t<\/tr>\n\t\t<\/thead>\n\n\t\t<tbody data-bind=\"visible: entries().length, foreach: entries\">\n\t\t<tr data-bind=\"attr: { 'data-entryid': id }\">\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f1.label, attr: { 'data-value': f1.label }\"\n\t\t\t\t\tdata-heading=\"Course Name\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f2.label, attr: { 'data-value': f2.label }\"\n\t\t\t\t\tdata-heading=\"Course Number\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f3.label, attr: { 'data-value': f3.label }\"\n\t\t\t\t\tdata-heading=\"Units\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f4.label, attr: { 'data-value': f4.label }\"\n\t\t\t\t\tdata-heading=\"Start Date\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f5.label, attr: { 'data-value': f5.label }\"\n\t\t\t\t\tdata-heading=\"End Date\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f6.label, attr: { 'data-value': f6.label }\"\n\t\t\t\t\tdata-heading=\"Add\/Drop\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f7.label, attr: { 'data-value': f7.label }\"\n\t\t\t\t\tdata-heading=\"Class Type\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t<td class=\"gpnf-row-actions\" style=\"display: none;\" data-bind=\"visible: true\">\n\t\t\t\t<ul>\n\t\t\t\t\t<li class=\"edit\"><button type=\"button\" class=\"edit-button gform-theme-button--secondary\" data-bind=\"click: $parent.editEntry, attr: { 'aria-label': 'Edit Course {0} where Course Name is {1}.'.gformFormat( $index() + 1, f1.label ) }\">Edit<\/button><\/li>\n\t\t\t\t\t\t\t\t\t\t<li class=\"delete\"><button type=\"button\" class=\"delete-button gform-theme-button--simple gform-theme-button--size-md\" data-bind=\"click: $parent.deleteEntry, attr: { 'aria-label': 'Delete Course {0} where Course Name is {1}.'.gformFormat( $index() + 1, f1.label ) }\">Delete<\/button><\/li>\n\t\t\t\t<\/ul>\n\t\t\t<\/td>\n\t\t<\/tr>\n\t\t<\/tbody>\n\n\t\t<tbody data-bind=\"visible: entries().length <= 0\">\n\t\t<tr class=\"gpnf-no-entries\" data-bind=\"visible: entries().length <= 0\" style=\"display: none;\">\n\t\t\t<td colspan=\"8\">\n\t\t\t\tThere are no <span>Courses.<\/span>\t\t\t<\/td>\n\t\t<\/tr>\n\t\t<\/tbody>\n\n\t<\/table>\n\n\t<button type=\"button\" class=\"gpnf-add-entry\"\n\t\t        data-formid=\"3\"\n\t\t        data-nestedformid=\"7\"\n\t\t\t\tdata-bind=\"attr: { disabled: isMaxed }, css: { 'gf-default-disabled': isMaxed }\"\n\t\t\t\t>\n\t\t\t\tAdd Course\n\t\t\t<\/button>\t\n\t\t\t<p class=\"gpnf-add-entry-max\" data-bind=\"visible: isMaxed\" style=\"display: none;\">\n\t\t\t\tMaximum number of courses reached.\n\t\t\t<\/p>\n<\/div>\n<input type=\"hidden\"\n                name=\"input_30\"\n                id=\"input_3_30\"\n                data-bind=\"value: entryIds\"\n                value=\"\" \/><div class='gfield_description' id='gfield_description_3_30'>Add one or more Courses.<\/div><\/div><div id=\"field_3_25\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Comments and Agreement.<\/h3><\/div><div id=\"field_3_21\" class=\"gfield gfield--type-textarea cucomment field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_21'>Comments<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_21' id='input_3_21' class='textarea medium'  aria-describedby=\"gfield_description_3_21\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><div class='gfield_description' id='gfield_description_3_21'>If you have any comments please enter them above.<\/div><\/div><fieldset id=\"field_3_22\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Agree to Terms<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\"> * <span class='sr-only'> Required<\/span><\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_3_22'><div class='gchoice gchoice_3_22_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.1' type='checkbox'  value='Agree'  id='choice_3_22_1'   aria-describedby=\"gfield_description_3_22\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_3_22_1' id='label_3_22_1' class='gform-field-label gform-field-label--type-inline'>Agree<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_3_22'><b>I certify that:<\/b><br \/>\n\u2022\tI am aware that only courses that are required for my degree objective will be certified. <br \/>\n\u2022\tI am aware that changes in my course enrollment and length of term of my courses may alter the payment the VA will award me.<br \/>\n\u2022\tI understand that I will be responsible for any overpayment I might receive for all unreported withdrawls or FW grades.<br \/>\n\u2022\tI am aware that I must fill out this form each semester after registering for classes.<br \/>\n\u2022\tI am aware that the certification process may take up to 14 days, so I am responsible for ensuring that I submit this request prior to the term payment deadline. \n<\/div><\/fieldset><\/fieldset><div id=\"field_3_27\" class=\"gfield gfield--type-captcha field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_27'>CAPTCHA<\/label><div id='input_3_27' class='ginput_container ginput_recaptcha' data-sitekey='6LdnShATAAAAAFLb7O2paFy9ZtLWttHkcZtCLSzc'  data-theme='light' data-tabindex='0'  data-badge=''><\/div><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' 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