Request V.A. Education Benefits Certification
In order to be certified for Education Benefits at North Shore Community College, please take a couple minutes to fill out this request form. This will provide us with accurate information, and allow us to be more proficient in our certifying.

Please fill out this form after registering for classes EVERY semester. We cannot certify you until you register for courses.
First Name *
Last Name *
Date of Birth (mm/dd/yyyy) *
Phone # (123-456-7890) *
Email *
What is your program of study? *
If you are a returning student, and have changed your program of study, you must inform Veterans Services
Which semester are you wanting to be certified for? *
Required
How many credits are you registered for? *
By checking the box, I certify that I have read the policy on course applicability and all the courses I am registered for will satisfy requirements outlined by my degree evaluation *
The VA will only pay for classes that are REQUIRED for your degree. Only courses that satisfy requirements outlined by the curriculum guide or graduation evaluation form can be certified for VA purposes. If a student takes a course that does not fulfill a program requirement, it cannot be certified for VA purposes. Excessive free electives, for example, cannot be certified.
Required
By checking the boxes, I certify that I have read the policy on Repeating Courses *
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.
Required
PLEASE LIST YOUR REPEAT CLASS (**if applicable)
What Educational Benefit are you planning to use? *
Have you submitted proper documentation to receive qualified benefits? *
(DD-214, Certificate of Eligibility, etc)
Have you been certified at NSCC before? *
Please be sure you have submitted your Certificate of Eligibility to the Veterans Service Office
Required
**POST 911/CHAP. 33 ONLY **Do you need NSCC Health Insurance to be included in certification for benefits? *
It is required by law that students must have health insurance if registered for 9 or more credits. If you are enrolled in VA Healthcare or have your own private health insurance, then you don't need the school health insurance so check no and be sure to log in to PIPELINE and WAIVE the school Health Insurance
Have you applied for FAFSA? (Financial Aid) *
If you haven't yet applied, it is a free application: www.fafsa.ed.gov is the website to apply. 002173 is NSCC's School Code. Many Veterans are entitled to Pell Grants. Be sure to apply!!
Additional Comments or Questions
You can use this space, if you have particular questions about your certification or if you need to leave a special instruction for your certification.
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