Certification Request Form

This form must be completed each semester that you want to use VA educational benefits. Submit the completed form after you have officially registered for your courses. Certification of enrollment to the Department of Veteran’s Affairs will not be submitted until this form is completed.

"*" indicates required fields

This form must be completed each semester that you want to use VA educational benefits. Submit the completed form after you have officially registered for your courses. Certification of enrollment to the Department of Veteran’s Affairs will not be submitted until this form is completed.

Student Status*
Are you graduating at the end of the year?*

Certification Request

Each term you wish to utilize VA educational benefits, a completed and signed Veterans Educational Certification Request form must be submitted.

Contact Information

All contact information must be current. Eagles email accounts must be checked regularly.

Eligible Courses

You can only request certification for courses that are required for the educational objective you declared. Classes not listed on your current graduation plan will not be certified.

Schedule/Enrollment Changes

You must notify the School Certifying Official, immediately, of any change in units (adds/drops/withdrawals) or program status, including termination of enrollment, change of course, major, etc.

Satisfactory Academic Progress

You must maintain satisfactory progress according to published standards established and enforced by Concordia University Irvine. The VA mandates that benefits must be discontinued when satisfactory progress has ceased.

Costs Not Covered By VA

You are responsible for paying Concordia University Irvine for any and all tuition and fees not covered by VA education benefits. Failure to do so may result in enrollment blocking, inability to request official transcripts, and eventually your balance could be transferred to collections. In addition, if you have any past due tuition and or fees, you will be unable to request future VA certifications at Concordia University Irvine.

By checking the agree box you acknowledge and understand the responsibilities listed above. You also authorize the School Certifying Official to certify your enrollment and provide academic record information to the Department of Veteran Affairs to ensure the receipt of Educational Training Benefits.

By checking the box below you agree to the terms and conditions*
* required