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Military Student Success Center

Spring 2022 CRF

VA Certification Request (Spring 2022 CRF)

This certification request is the responsibility of the student. All sections of this form must be completed.

Students wishing to receive VA educational benefits will not receive them unless they are certified each semester.

For inquiries, please contact the UALR Office of Military Student Success at O: (501) 916-3387 / F: (501) 683-7055 / email: military@ualr.edu. Please do not submit the form until after you have registered for classes.

Step 1 of 4

25%

Have you registered for classes for this semester?*
You must be registered before you submit your CRF.
- Yes
- No
By submitting my UA Little Rock VA Certification Request form, I acknowledge that I have read and understand the following:*
- I have read agree to all the statements found below.
- I understand the UA Little Rock Office of Military Student Success will certify my registration and ensure my class selections will not be deleted.
- I understand the UA Little Rock Office of Military Student Success has to report dropped classes, term withdrawals, incomplete grades, non-developmental NC (No Credit) grades, and non-attendance grades to the Veterans Regional Office which may result in an over payment.
- I authorize the UA Little Rock Office of Military Student Success to certify enrollment information to the Veterans Regional Office.
- I understand VA will not pay for a course already passed at an acceptable level at UA Little Rock or any other school - (Check with your advisor: a grade of "D" may be an acceptable grade for your degree requirement) UA Little Rock's official method of correspondence with students, including billings, is via the UA Little Rock assigned email address. I accept my responsibility to access my UA Little Rock assigned email account regularly and to take any required action.
- I understand that the VA will not pay for an online remedial class.
- I authorize UA Little Rock to apply any veteran educational benefits I receive toward my account balance. If my educational benefit is reduced or canceled, I understand that I will be fully responsible for all charges and should immediately contact the Student Accounts Office.
- I understand that if my benefits exhaust before or during the term, I will be fully responsible for all charges and should immediately contact the Student Accounts Office.
- I understand that UA Little Rock will assess financial penalties on any past-due accounts. At semester end, I understand that if I have a past-due account, my account will be referred to an outside collection agency and result in additional charges.
- I am responsible for reading and understanding the current Drop/Withdrawal refund policy of UA Little Rock as it appears on the Bursar's website at ualr.edu/bursar.
- I understand I must enroll in classes required for my degree/major.
- I understand I have made a contractual financial obligation to pay all tuition and fees associated with any classes in which I register, unless I withdraw by the deadlines listed below. "Not Attending" does not remove this obligation.

What semester do you want certified for VA educational benefits?*
- Spring 2022
This submission is:
- Initial submission
- Update because of change in enrollment
Please submit one semester at a time. Thank you.
Important Dates
The Bursar’s Office (the Office of Student Accounts) Website has both the payment dates or refund schedule.

For important Academic dates, (days to register, drop dates, graduation, etc.) refer to the Academic Calendar. This includes deadlines and academic events for the current semester(s) and links to previous semester calendars.
Name*
First Last
Student ID (T00######)*
Phone*
Address*
We have added this field to the CRF, because the VA uses the address that is in the VA Once system to mail any information to you. We want to make sure the address they have is correct.

Street Address Address Line 2 City State ZIP Code
Email*

UA Little Rock's official method of correspondence, including billings, is via the UA Little Rock-assigned email address. If you do not use your ualr.edu email address, please use an email address other than Yahoo! for this form.
List your major*
Example: Mathematics

Educational Benefit(s) Used*
Who is your VR&E Counselor?*
Is this a different VA educational benefit from last semester?
- Yes
- No
If "Yes," we will need a new Certificate of Eligibility (COE) or VA form 28-1905 for the new benefit.
Are you on active duty?*
- Yes
- No
Will you receive other tuition assistance for this semester? (i.e., TA, employee discounts, scholarships, etc.) - This does not include student loans or pell grants*
- Yes
- No
The VA requires us to deduct any tuition-specific aid from your tuition and fees before we post them in VA Once.
What other aid are you expecting to receive?*
Will you be attending a school other than UA Little Rock for the semester being certified?*
- Yes
- No
What is the name of the school?
Are the classes you are taking working towards your degree plan and graduation?*
The VA will not fund courses that are not required for your degree plan or graduation. If you are not sure if your classes meet this requirement, email military@ualr.edu.
- Yes
- No

Total hours enrolled*
Total hours to certify*
This may be different from the "Total hours enrolled." if you are not using your VA educational benefits for all of the credits you are taking. It will be the same as the "Total hours enrolled." if you are using your benefits for all of your classes.
I understand how many hours are required to be part time/full time, and I understand my benefits will be affected by the amount of hours I am in.
- Yes
If you do not understand the requirements for part-time and full-time, please visit https://ualr.edu/military/benefits-by-chapter/ and va.gov or call the Military Student Success Office at 501.916.3387.
By submitting this form, I agree to notify the UA Little Rock Office of Veterans Affairs should I change my major or adjust my schedule. Schedule changes may result in an overpayment.*
- I have provided accurate information and agree to comply with all Veterans Regional Office Guidelines.
New Parking Permit*
Please initial here to acknowledge that if you have a registered your vehicle with Public Safety and that VA educational benefits will not reimburse this fee as it is not charged to every student.
Degree Plan or Advising Form (Not Required to Submit Form)
The VA requires us to have an advising form (each semester) or a degree plan* on file for you.

*Note: Once we have a degree plan, you will not have to submit anything else, unless you change majors.

You may upload your degree plan or advising form if you have one. If not, we will check and see that you have one on file.

This is not required to submit the CRF.
Military Student Success Center Use Only
The information below is to be filled out by the MSSC staff.

You will need to log into BANNER to complete most of the following information.
Residency Code (Found in SGASTDN-Learner tab)
- M-All Active Duty and Veterans should have this code
- R or A-All Dependents should have either of these codes
- O-This is for Out-of-State students. If any of our military students have "O," contact Linda Czir.
Should be M or R, sometimes A
- If the student is a Veteran, they should have an "M" residency code. (Ch 1606 should have "M")
- If the student is a dependent/spouse, they should have an "R" code.
- Email Linda Czir to make corrections for residency code. (laderden@ualr.edu)
Class (Found in SGASTDN-Learner tab)
- Freshman
- Sophomore
- Junior
- Senior
- Law
- Graduate
- Post Bac
Proof of Eligibility (Found in SGASTDN-Activities tab)
- Yes
- No
- COE (Chapters 1606, 30, 33, and 35)
- 1905 (Chapter 31)
Advising Form or Degree Plan (Found in SGASTDN-Activities tab)
- Yes
- No
An advising form tells the student what needs to be taken this semester.
A degree plan tells the student what needs to be taken to complete his or her degree.
Have you annotated the "Activities" tab in SGASTDN to reflect CRF receipt?
- Yes
- No
Have you put a "C" code on the "Veteran" tab in SGASTDN?
- Yes
- No
An advising form tells the student what needs to be taken this semester.
A degree plan tells the student what needs to be taken to complete his or her degree.
Does the school program in VA ONCE and DegreeWorks match?
Ensure the correct degree program is selected in VA ONCE.
- Yes
- No
Is the training type correct in VA ONCE?
It should be marked undergraduate for students approaching an undergraduate degree and graduate for students seeking a graduate degree.
- Yes
- No
Do any courses fall into excessive electives?
The VA will not pay for a course that is not required for their degree plan or graduation. Ensure that the course is required for the degree. There are circumstances that excessive electives are acceptable, such as prerequisites.
- Yes
- No
Why is/are the excessive class(es) necessary?
Repeating Classes (Found in-SHACRSE or SFAREGS)
Is the student repeating Classes?

The following is from the SCO Handbook:
"Classes that are successfully completed may not be certified again for VA purposes if they are repeated. However, if a student fails a class, or if a program requires a higher grade than the one achieved in a particular class for successful completion, that class may be repeated and certified to VA again."
- Yes
- No
What class (es) is/are repeated?
Please list course number (e.g., RHET 1312)
Is the student in any development/remedial classes?
- Yes
- No
Is the student taking any development classes online?
The VA will not pay for development/remedial courses online. We cannot certify them.
- Yes
- No
STOP! The student CANNOT take developmental/remedial courses online.*
Were the development/remedial courses certified in the R/D section of VA ONCE?
- Yes
- No
Is the student in multiple terms?
Ensure each course is certified under the appropriate term.
- Yes
- No
Record all documents in ImageNow
- Yes
- No
Go to SPAIDEN to link student's information from BANNER to ImageNow.

Note: CRF, COE, Degree Plan, Advising Form, 1905, Certification-are all forms that need imaged
Check all that are appropriate
Explain Other
School Certifying Official Action (SCO will fill out)
Name of SCO Doing Certification
This is important in case there are any questions about certification.
Has student been certified in VA Once?
- Yes
- No
Has information certification been updated in BANNER (SGASDTN)?
- Yes
- No
Untitled
Phone
Phone
Phone
Email
This field is for validation purposes and should be left unchanged.

Contact
- Military Student Success
- UA Little Rock
  Speech Building, Room 111
  
  Little Rock, AR 72204
- Email: military@ualr.edu

University News
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Spring 2022 CRF

VA Certification Request (Spring 2022 CRF)

Step 1 of 4

Important Dates

Military Student Success Center Use Only

The information below is to be filled out by the MSSC staff.

You will need to log into BANNER to complete most of the following information.

Should be M or R, sometimes A

School Certifying Official Action (SCO will fill out)