VA Educational Benefit Certification Request

Purpose: This form is required for students requesting certification of VA education benefits. Submission of this form does not guarantee payment of benefits. Certification cannot occur until all required documentation is received. This form must be completed each semester you would like your enrollment certified to VA.

Student Information

Student Name

Student ID:

VA Benefit Information

VA Benefit Chapter (check one):

Chapter 33 - Post-9/11 GI Bill®

Chapter 30 – Montgomery GI Bill®

Chapter 35 – Dependent's Educational Assistance

Chapter 1606 - Montgomery GI Bill-Selected Reserves

Chapter 31 – Veteran Readiness & Employment

Have you previously used VA education benefits?

Yes

Are you a Veteran, Active Duty or Dependent?

Veteran

Active Duty

Dependent Child

Dependent Spouse

Dependents will need to provide the name, date of birth, and social security number of the veteran or active-duty service member. Please contact the Financial Aid Office.

Program of Study

Declared Program

Only courses that are required for the declared program of study may be certified for VA benefits.

Did you change your program or major since the last semester you received benefits?

Yes

Effective term

Term Certification Request

Fall 2026

Spring 2027

Summer 2027

Prior Credit Disclosure

I have submitted all prior college transcripts and/or Joint Services Transcript (JST/JLT)

I have no prior credit/transcripts

Have you applied for your VA Education Benefits and provided us with a copy of your Certificate of Eligibility from VA? If not, please upload it below.

Yes

Have you applied for your VA Education Benefits and provided us with a copy of your Certificate of Eligibility from VA? If not, please upload it below.

Upload Certificate of Eligibility

One file only.
100 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.

COF (College Opportunity Fund)

The state of Colorado offers a tuition stipend called the College Opportunity Fund (COF) https://cof.college-assist.org/ as a student receiving VA Education benefits. You qualify for this stipend even if you are not a Colorado Resident. If you choose to use the COF stipend it will pay $116 per credit hour, up to a total of 145 credit hours, towards your tuition. If you choose to use this stipend, NJC will bill tuition minus $116 per credit hour to the VA. If you choose to decline the use of COF, NJC will bill the full amount of tuition to the VA. If you choose to use the COF stipend it does need to be authorized or declined each semester through AccessNJC, on the Student Finance Card. If you do not choose an option, we will certify tuition minus $116 per credit hour to the VA. Once the semester ends if you have not chosen to authorize the use of the COF stipend, we will bill the VA the difference once you can no longer use the stipend. This could delay your bill getting paid with NJC. Please notify the School Certifying official with your decision financialaid@njc.edu. If you choose to decline COF at the beginning of the semester and change that decision later, it will result in an overpayment from VA. NJC will send the overpayment back to VA and you as the student will owe that overpayment amount to NJC.

I understand COF needs to be authorized or declined per semester. Please indicate your decision, you will still need to authorize your COF in AccessNJC, on the Student Finance Tab.

Yes I will be authorizing COF

No I will be declining COF

Student Responsibilities & Acknowledgement

Please read and acknowledge each statement:

I understand I must notify the School Certifying Official immediately if I add, drop, withdraw from, or stop attending any course.

I understand I must notify the SCO of any program or major change.

I understand that failure to report changes may result in an overpayment and debt to the Department of Veterans Affairs.

I understand that submission of this form does not guarantee payment of VA benefits.

I understand that NJC will only certify classes to the VA that are applicable to my degree/certificate program.

I understand I must submit this form each semester. Your enrollment will not be certified to VA during the semester without this form completed.

This is how the NJC school certifying official will know to certify your enrollment to the VA.

I understand that NJC will contact me at my student email with any issues. I understand I must regularly check my student email.

I understand that developmental courses (ENG and MAT classes that start with a 0) must be classroom based. VA will not pay for any other instructional method (online). I must also provide justification for developmental courses by taking a placement exam.

I understand that changes to my schedule could result in a debt to the school and or the VA. It is my responsibility to resolve those debts.

Signature

By signing this form I agree:

I am required to submit a Certificate of Eligibility from the VA to have my educational benefits certified.
It is my responsibility to understand how my VA education benefits work. https://www.va.gov/education/about-gi-bill-benefits/
I am ultimately responsible for my student bill at NJC.
I understand NJC will only certify tuition and fees to the VA, housing and meals are my responsibility along with any outside charges incurred.

Signature
I understand that by electronically signing this document by signing my full legal name, that I acknowledge, agree, and attest that the information provided by me is true and correct and I am freely intending to create and adopt this signature as my own legal binding electronic signature that carries the same legal effective and enforceability as my handwritten signature.

Student Signature

Sign above