Student Responsibility Form printable pdf download

SVC’s Veterans Office

Student responsibility form (required )

Student Id #:____________

Request For: New Student _____

Change of VA Benefit Chapter_____

Change of Degree Plan_____

Effective Quarter: Fall ____

Winter_____

Spring_____

Summer_____

Chapter 33

Chapter 33/Dependent

Chapter 30

Chapter 35

Chapter 1606

Chapter 1607

Chapter 31

Last Name:_______________________________, First Name:___________________________, Student SSN:_________________

Mailing Address:_________________________________________________________________________________________________

Number, street or box

Ci t y , S t a t e

Zip Code

Telephone:________________________________________ Note:

All email correspondence is sent to your Skagit Valley College email address.

I have attended other post-secondary institutions:

Yes

If yes, list all institutions attended:

____________________________________

I have completed my VONAPP Application Online:

Yes

Student must read, initial each line, and sign the bottom of this form in order to receive GI Bill benefits.

_____1. My degree is: __________________________________ * Only 1 degree per quarter is allowed unless a dual program has been approved.

I understand that I am required to enroll in classes that fit my selected degree plan and that the GI Bill will not be approved for any

classes that do not fulfill my degree plan requirements.

_____2. I will contact SVC’s-Veterans Office each and every quarter to report my registration, drop, or add of any classes.

_____3. I am aware that I am responsible for payment of any tuition charges that are not covered by my GI Bill, not paid by

Veterans Affairs, or for a class that is not approved under my GI Bill. I must make payment by the designated date or I could be dropped

from my classes.

_____ 4. I am responsible to provide an official transcript from all schools that I have attended regardless of accreditation and

my military transcript before my certification will be processed.

_____5. I have been made aware that transferred classes that fulfill a requirement on my Skagit ValleyCollege degree may

result in an over payment if I take a class that also fits this same requirement. This class will be removed from certification.

_____6. I am aware that VA regulations do not allow GI Bill certification for any developmental course that is taken

online. Any developmental online course will not be certified for benefits and I will be responsible for the payment of this class.

_____7. I have been made aware that Skagit Valley College accepts transferred credit for classes passed with a 'D' or better,

therefore an overpayment may result if I retake one of these transferred classes.

_____8. I am aware that the VA calculates rate of pursuit by dividing the credit hours being pursued by the number of credits

considered to be full-time by the school. The resulting percentage is my rate of pursuit. The Chapter 33 housing allowance is paid if

rate of pursuit is more than 50%.

_____9. I am aware I must inform my campus Veterans Office, if I will be receiving federal financial aid, grants or scholarships.

STANDARD OF PROGRESS

_____ 10. I understand that if I am placed on academic suspension by my school for any reason that this could result in the loss of my

GI Bill benefits and the Veterans Administration could recoup all benefits from the entire quarter. I am aware that I will not

be certified for any courses while on academic suspension.

_____11. I understand that if I drop a class the Veterans Administration may require repayment of the dropped class and I am respons ible for

repayment.

I have read and understand my responsibilities. I have received a copy of my responsibilities and a copy of the SVC student GI Bill Policies

Guide book.

Signature: ________________________________________________________

Date: ______/______/_______

Student Responsibility Form

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