Name(Required) Date(Required) Athens State Student ID Number(Required) Entering Semester(Required)Summer '23Fall '23Spring '24Summer '24Fall '24Spring '25Summer '25Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home PhoneWork PhoneCell PhoneAthens State Email(Required) Major(Required) Minor VA Benefit Chapter(Required) Montgomery GI Bill (CH30) Rehabilitation (CH31) GI Dependent (CH35) Post 9/11 (CH33) National Guard/Selective Reserve (CH1606) If Chapter 35, VA Claim Number Are you currently on Active Duty?(Required) Yes No Please read and check the statements listed below(Required) To begin VA benefits at Athens State University, I will submit a Certificate of Eligibility, the Statement of Understanding form, and a Certification Request for VA benefits form to the VA Educational Assistance Office at Athens State University. I will submit the Certification Request for VA benefits form to the Veterans Educational Assistance Office each semester that I would like to receive VA benefits. lf I change my address, phone number, major, hours enrolled (drop/add), total withdrawal, last name, etc. at any time during a semester or if I make changes before the semester begins, I will notify the VA Office IMMEDIATELY of these changes. VA will only pay for courses that meet graduation requirements for my degree plan. I understand that if I take a course and then receive prior credit for the course (includes military credit applied for); I will have to pay the VA back for the course taken at Athens State University. VA will only pay for courses that apply to my degree plan which includes the general education requirements, pre-professional requirements, professional requirements, and electives if needed. I understand that it is my responsibility and in my best interest to meet/make contact with my assigned faculty advisor every semester to make sure I am taking the classes I need to graduate (degree-seeking students only). The VA will not pay for a minor unless it is required for my major. I understand that I must submit a VA Certification Request to the Athens State VA Office each semester so that my class schedule will be submitted to the Department of Veteran Affairs. I understand that if I’m receiving the Post 9/11 benefits, I’m responsible for purchasing of my books with the understanding that I will receive a book stipend to help offset the cost of my books. I understand VA will only pay for courses that apply to my degree plan which includes the general education requirements, pre-professional requirements and electives if needed. VA will not pay for a minor that is not required to receive a degree. I understand that it is my responsibility to meet with my faculty advisor each semester to make sure I am in the correct courses for my degree. I understand if I change my hours enrolled (drop/add) or withdraw at any time during a semester or if I make changes before the semester begins, I will notify the Athens State VA office immediately of these changes. I understand that if I withdraw from a class, my educational benefits could be liable for recoupment. I understand that I am responsible for any recoupment to the Department of Veterans Affairs. As a Chapter 30, 1606 or 1607 recipient, I understand I must verify enrollment and attendance with the Department of Veterans Affairs each month online at www.benefits.va.gov/gibill or by calling 1-877-823-2378. I understand that if my educational benefit doesn’t cover the total cost of my tuition/fees, I am responsible for the balance. (Post 9/11) I understand that I am responsible for tuition/fees if my VA benefits are in the process of being approved. Athens State University will review my account for overpayments made by the VA and return money that is due to me for classes that I have paid for while my benefits were in the process of being approved. I understand that I must submit a copy of my Joint Service Transcripts to the VA Educational Assistance Office within eight weeks of my enrollment. I must request for an official copy of my military transcript to be sent to Athens State University. Army, Coast Guard, Marines, National Guard, and Navy Transcripts can be requested at jst.doded.mil/official.html. Members of the Air Force can request official copies at www.airuniversity.af.edu. I understand that if I have questions concerning a delay in payment or monthly attendance verification issues, I will contact VA education benefits at 888-442-4551 or via e-mail inquiry through Ask a Question online at www.benefits.va.gov.gibill. I have read the above statements and understand my responsibilities.Student Name(Required) Date(Required) Δ