Request for Certification

This form should be completed each semester after you have a finalized course schedule.

If you see this don't fill out this input box.

*First Name:

*Last Name?

*LoLA #

*Social Security #

VA File # (Required for Ch. 35 users)

*Address

*City

*State

*Zip Code

*Home Phone

Cell Phone

*Email Address

Alternate Email Address

Primary Major (Must be listed in LoLA)

Secondary Major (Must be listed in LoLA)

Student Status

Are you using Louisiana National Guard Tuition Exemption. (Speak with the bursar's office every semester to use this benefit)

Are you using LA Dependent's Tuition and Fee waiver certificate? (Must present this certificate to the bursar's office every semester)

Are you being charged non-resident fees? (You must submit a Veteran/Service Member/Dependent/Spouse Non-Resident Tuition Waiver Request Form to have this adjusted)

Please select the benefit you are using:

Read each line carefully and provide your initials for each line

*The VA Counselor will contact me by email if there are any issues with my certification.

*Please allow at least 30 days for processing of my benefits.

*I must submit this form every semester in order to receive my benefits.

*Only classes that are required for my degree or certificate can be used for my benefits. (Includes prerequisites, developmental classes and course substitutions) I may be asked to verify classes.

*Dropping or changing my schedule can result in a debt to the VA.

*It is my responsibility to ensure that my class schedule has been secured. My classes will be dropped if I do not make payment arrangements by the payment deadlines listed in the DCC handbook.

*The VA does not allow developmental classes (ENGL 060/061/062, READ070/071/072, MATH090/091/098/099) to be taken as an online class or a hybrid class.

*General Studies and Louisiana Transfer degree majors are required to submit a degree plan every semester. Failure to do so may cause my certification to be delayed or not submitted. (See an advisor)

*Students using the following benefits must call or verify attendance online each month to receive their payments. (Ch. 30. Ch. 1606 and REAP) You can verify at 1-877-823-2378 or at www.va.gov

Post 9/11 GI Bill Students

*I am responsible for my tuition and fees at Delgado if my Post 9/11 GI Bill fails to come in for any reason.

*The Post 9/11 GI Bill Does not cover non-resident fees. You must submit a Veteran/Service Member/Dependent/Spouse Non-Resident Tuition Waiver Request Form to the Admissions office to adjust this.

*Taking halftime (6 credits for Spring/Fall, 3 credits for Summer)or less will make me ineligible for a monthly housing allowance.

*Taking all online and/or hybrid classes will result in receiving half of the national average for your monthly housing allowance. I must be enrolled in at least one traditional face to face course.

*Any refunds due to me will be processed per the refund policy of Delgado Community College. VA funds may be dispersed later than other financial aid. Please be patient with the processing of payments.

*When I submit this form along with my certificate of eligibility, DCC will place a temporary credit on my account to keep my classes from being dropped. (Credit can change based upon actual payments)

*Please note that The Post 9/11 GI Bill will not cover the following fees: Application Fee, Testing Fees, Late Registration Fees.

Additional Info:

*I agree that the courses I am registered for this semester count toward my CURRENT MAJOR AT DELGADO (as listed in LoLA). I understand that if any of the courses that I am taking do not apply to my degree, they WILL NOT be certified and that I will be responsible for the cost. I also agree to allow the reporting of my enrollment status to the Department of Veterans Affairs for the purpose of receiving education benefits.

Semester