JWCC Veteran Student Enrollment Certification

Benefit codes:
- 30: Montgomery GI Bill
- 31: VA Voc Rehab
- 33 (p911): Post 911 GI Bill
- 35: GI Dependent
- 1606: National Guard and Reserve

Select term:

Select term: Fall Spring Summer Winter
Choose benefit(s) to use:

Choose benefit(s) to use: 30 31 33 (P911) 35 1606 Illinois Veterans Grant Illinois National Guard Grant
Name Name First Last
JWCC ID Number
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone - ### - ### ####
Email
Program of Study
By submitting this form:

1. I certify that all of the courses for which I register each term will be required to complete my degree/certificate requirements in my designated program of study (i.e., the program reported to the U.S. Dept. of Veterans Affairs).
2. I understand that I must submit academic transcripts for each college, university and/or trade school I have previously attended and that my service record must be evaluated for possible credits. Transcripts must be submitted to JWCC prior to second semester of enrollment.
3. I understand that coursework not approved for VA benefits and/or required in my program of study cannot be included in training time.
4. I understand that the VA does not pay for any developmental online courses.
5. I agree to notify the JWCC Veterans Education Office if I add, drop or withdraw from any class(es).
6. I agree to notify the JWCC Records Office and JWCC Education Office of any change to my program of study (academic concentration).
7. I understand that I must meet the academic standards of the college and for VA as indicated in the JWCC catalog.
By signing, you agree to the terms listed above.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date Date / MM / DD YYYY

JWCC Veteran Student Enrollment Certification

JWCC Veteran Student Enrollment Certification

By submitting this form: