26-27 VA Education Benefit Req

BMCC Financial Aid Office
2411 NW Carden Ave
Pendleton, OR 97801
Phone: 541-278-5779
Fax: 541-278-5889
Email: FinancialAid@bluecc.edu

BMCC ID

Name

First NameLast Name

Email address

example@example.com

BMCC Degree intent

Phone number

Format: (000) 000-0000.

VA Education Benefits Chapter (mark one only)

Students Payee Number

Name of Veteran

Veterans VA File Number

VRE Counselor

By signing below, I acknowledge that I am pursuing a degree or certificate offered by Blue Mountain Community College.

I understand it is my responsibility to maintain satisfactory academic progress, and I must immediately report any changes to myschedule to BMCC’s VA School Certifying Official (SCO); failure to do so may result in an overpayment of benefits that I amresponsible to repay. I also acknowledge that I understand only those courses leading to my designated degree or certificatewill be certified by BMCC’s VA SCO. I further understand that I am responsible for the amount of my tuition & fees not paid bythe VA.

My signature also authorizes the BMCC VA SCO to release my academic information regarding benefits, enrollment, andgrades to the Department of Veteran’s Affairs and all other organizations involved with the processing and monitoring of VAEducation Benefits. In addition, my signature authorizes BMCC’s VA SCO to share that I am using VA education benefits with my Faculty Advisor and Navigator to accurately certify my enrollment.

I have attached a copy of my Certificate of Eligibility letter, or Statement of Benefits or Education Enrollment Status(from e-Benefits).

I have attached a signed Statement of Rights and Responsibilities form (page 2 of this packet).

I have attached a signed completed Prior Enrollment form (page 3 of this packet).

SIGNATURE

DATE

Date

File Upload

NOTE: INCOMPLETE PACKETS WILL DELAY PROCESSING

BMCC Financial Aid Office
2411 NW Carden Ave
Pendleton, OR 97801
Phone: 541-278-5779
Fax: 541-278-5889
Email: FinancialAid@bluecc.edu

NAME

BMCC ID

It is my responsibility to monitor my BMCC student email account for all communications from the BMCC VA School Certifying Official (SCO) and other offices of the College.

I must be pursuing a BMCC degree or certificate to be eligible for Veterans Education Benefits. I must notify the BMCC SCO if I change my degree intent, which will result in a re-evaluation of my degree plan.

I understand that the SCO may only certify enrollment for those courses that are required for my stated degree or certificate. I am responsible for payment of tuition, fees, and materials which are not paid by the VA. I must work with an Academic Advisor and/or Navigator to ensure progress toward my stated degree or certificate.

If I register for classes, it is my responsibility to pay my tuition in full (or make satisfactory payment arrangements) whether the VA does not pay due to my running out of education benefits or other issues with my education benefits. I understand I may incur a financial hold on my account.

I must report any enrollment changes to the SCO. The VA will administer benefits based on my attendance. If I stop attending for any reason, or receive FA (Failure due to Attendance) grades, my last date of attendance will be reported to the VA and I am responsible for any overpayment (student debt) which this may create.

The VA will not pay for online remedial courses, self-paced classes, audited courses, non-credit classes, or repeats of successfully completed classes. If I select any of these grading options, an overpayment (student debt) may occur which I am responsible for paying for.

I will be responsible for paying any tuition and fee overpayment to BMCC and a hold will be placed on my account until it is paid. I may also be responsible to the VA for any book stipend or housing allowance debts.

I must maintain Good Academic Standing per the BMCC Institutional Academic Progress Policy.

If academically suspended, my entitlement will be terminated unless I successfully appeal my status and I am granted are instatement. It is my responsibility to notify the SCO of any changes in my academic status.

I have read and understand the above statements and authorize BMCC to certify my VA educational benefits. I authorize BMCC to release information about me necessary for the processing of my VA educational benefits. I understand a file will be maintained by the college to meet compliance with VA regulations for reporting and record keeping purposes. I understand I am solely responsible for contacting the VA and/or the BMCC SCO with questions regarding my file. College records maybe reviewed by authorized VA representatives to ensure compliance with applicable laws and regulations.

NOTE: BMCC's SCO is not directly associated with the Veterans Administration. Based on information provided by you, along with college records, we certify your enrollment to the VA for their determination of your payment eligibility. Questions regarding pay or eligibility must be addressed with the VA at the Student Education Call Center at 1-888-442-4551.

SIGNATURE

DATE

Date

BMCC Financial Aid Office
2411 NW Carden Ave
Pendleton, OR 97801
Phone: 541-278-5779
Fax: 541-278-5889
Email: FinancialAid@bluecc.edu

NAME

BMCC ID

Please list below the names of any school you attended after high school, regardless of whether you used VA Education Benefits, and whether or not credit was earned. If you have more than five prior schools, please list them on an additional piece of paper.

Rows	Name of Colleges Attended
1)
2)
3)
4)
5)

OR

SUBMIT OFFICIAL TRANSCRIPTS

My signature below indicates that I understand:

It is my responsibility to submit official academic transcripts from all institutions that I have previously attended, whether or not VA benefits were received. It is also my responsibility to submit a Transfer Credit Evaluation Request online so that those transcripts will be evaluated toward my declared degree intent.
BMCC's SCO will only certify one term for VA benefits without having an official evaluation of the above-mentioned transcripts on record. In some circumstances, a second term will be certified if I provide proof that an evaluation is in progress. If I am unable to order my transcripts, I must submit a signed and dated written statement explaining why I am unable to order transcripts.
I will be responsible for paying any tuition and fee overpayment to BMCC which are the result of classes that were certified at BMCC which were previously successfully completed at another institution. I may also be responsible to the VA for any book stipend or housing allowance debts.
Any inquiries regarding my Transfer Credit Evaluation Request should be directed to the BMCC Service Center at (541)278-5759 or to Getlnfo@bluecc.edu.
Evaluation of my transcripts may take up to eight weeks, so it is important to start this process early. It is my responsibility to notify BMCC's VA SCO when my official transcript evaluation has been completed.
The information that I have provided above is accurate and complete to the best of my knowledge.

SIGNATURE

DATE

Date

It is the policy of the Blue Mountain Community College Board of Education and School District that there will be no discrimination or harassment on the grounds of race, color, sex, marital status, sexual orientation, religion, national origin, age or disability in any educational programs, activities or employment. Persons having questions about equal opportunity and nondiscrimination should contact the BMCC Title IX Coordinators Room M-12 Morrow Hall, Blue Mountain Community College, 2411 NW Carden, Pendleton, OR 97801, Phone: 541-278-5947. Email: hr@bluecc.edu. For hearing impaired assistance please call Oregon Relay at 7-1-1.

My initials in each box below indicate I understand: