Request for Certification Form (West Bank and Jefferson)

Note: This form is intended for students of the West Bank Campus and the Jefferson Site.

If you are a student of online programs, the City Park Campus, the Charity School of Nursing, and the Sidney Collier Site, please submit the other request for certification form.

All Students
Read each line carefully and provide your initials for each line. If the information doesn't apply to you, please enter "NA" for not applicable.
Post 9/11 GI Bill Students
The following section pertains to Post 9/11 GI Bill students only. If this does not apply to you, please enter "NA" for not applicable.