FOLLOW STEPS TO COMPLETE THE VETERAN CERTIFICATION REQUEST (VCR)

Download Adobe Reader DC

***You Must Have The Latest Adobe Reader Installed To Fill Out the VCR Form!!!***

Step 1a: Go to the following URL to download Adobe Reader DC from the website: get.adobe.com/reader/

NOTE: Before starting the Adobe Reader DC, please be sure to use Google Chrome browser.

NOTE: Make sure the URL is exactly the same as above, as it will detect your operating system.

Step 1b: Next, uncheck the optional offers in the second box click Download Acrobat Reader.

NOTE: A download package will begin at the bottom of the browser.

Step 1c: Once the download package is complete, Open the downloaded Adobe Reader DC package at

the bottom of the browser.

Step 1d: An Install window will appear like below. Once the install is complete with the check marks,

click Finish.

NOTE: Adobe Reader DC is now installed and available to use on your computer.

If you are having any issues, please contact Palm Beach State College Help Desk: (561) 868 – 4000

https://www.palmbeachstate.edu/servicedesk/default.aspx

Download and Save Veteran Certification Request (VCR) Form

Step 2: Download and Save the Veteran Certification Request (VCR)

Fill out VCR Form in Adobe Reader

***To Complete The VCR Form You Must Open In The Latest Version Of Adobe Reader!!!***

Step 3a: To fill out your VCR, please open the VCR Form in Adobe Reader DC. (NOT A BROWSER)

NOTE: You may have to right click on the VCR Form file and select “Open with” Adobe Reader.

Step 3b: In the top section, enter your First Name, Last Name, Student ID, Phone Number and School

Email.

Step 3c: Next, Select the “VA Education Benefits” you are planning to use for the semester and enter all

information for that specific education benefit.

Step 3d: Select the semester, Fall, Spring or Summer.

Step 3e: Check the Academic Program that applies to you. If you are in a Degree Program, click the

first fillable box and select AA, AS, BAS, or BSN and then type your program name in the

next fillable box.

Step 3f: Next, Fill out the “Current Registered Semester Schedule” section with all your registered

classes. To do this, pull up your schedule from Pantherweb and use it as a reference.

Step 3g: SKIP “Academic Advisor Certification” as your advisor will fill out this section out.

Step 3h: Sign beside “Student Signature” by clicking the fillable box and typing your first and last

name.

Step 3i: Enter the current date by clicking the fillable box beside “Date”. For Example: 03/03/2010

Step 3j: Read the Memorandum of Understanding. Then, sign again at the bottom of page two, in the

fillable box above “Signature”.

Step 3k: Enter the current date by clicking the fillable box above “Date” at the bottom of page two.

For Example: 03/03/2010

NOTE: If you don’t have Outlook installed please do so, as it is important for students to use their

college email to communicate with faculty.

Submit PDF Veteran Certification Request (VCR) Form

Step 4: There are two options to submit the form:

Option 1: This option requires you to have Outlook installed on your computer.

1a: Click the drop-down beside “Select Your Veteran Academic Advisor” and select your advisor.

Also listed with the advisor’s name is the campus location if you are unsure.

1b: Click “Submit VCR to Advisor”. Select “Default email application”, then “Continue”.

1c: Once email appears in Outlook, click “Send”.

NOTE: If you don’t have Outlook installed please do so, as it is important for students to use their

college email to communicate with faculty.

Option 2: This option requires students to save the form after filling it out and emailing the form to

their preferred advisor (Bachelor's, Student Accessibility, etc.).

2a: Go to File, Save As, and name the document as: YourStudentID_RemoteVCR.

For Example: J12345678_RemoteVCR

2b: Attach the PDF form in an email and submit the email to your preferred Academic Advisor.

Veteran Academic Advisors emails:

Lake Worth Campus| Christopher Shanks| shanksc@palmbeachstate.edu

Boca Raton Campus| Erica Weissman| weissmae@palmbeachstate.edu

Palm Beach Gardens Campus | Ashton Davis | davisa@palmbeachstate.edu

Loxahatchee Groves Campus | John Maloney | maloneyj@palmbeachstate.edu

VETERAN’S CERTIFICATION REQUEST (VCR)*** Latest Version of Adobe Reader Required ***

First Name: ___________________________ Last Name: __________________________ Student ID: _____________________

Phone: ( ) __________-______________ Student Email: _____________________________________________________

Academic Program Information (Your program must agree with that listed in the college’s official record)

Current Degree program : _________________________________________ PSAV/CCC: ______________________

Law Enforcement Academy: ______ Cross Over Academy: ________ Corrections Academy: _______ Fire Academy: ________

Current Registered Semester Schedule Course ID

(Example: ENC1101) Start Date

(Example: 10/10/2010) End Date

(Example: 10/10/2010) Credit | Clock Hours

(Example: 3.0) Course Type(Example: Online)

Campus (Example: Lake Worth)

1.

2.

3.

4.

5.

6.

7.

Academic Advisor Certification

Academic Advisor Certification Section:Exceptions: transient students submit a transient form from your primary institution. Criminal justice (i.e. Law Enforcement, Corrections, or Cross-Over) and fire academy do not require am advisor’s signature but are required to attach acceptance letter.I certify that course(s) listed above are required to complete the student’s current primary program of study. Initial

I certify the student has been advised that JST or CCAF Military Transcript are required and mandated by VA Education. Initial

I certify that the student has been advised that to receive full benefits he/she must be enrolled in a full-time schedule. Initial

Advisor’s Name: Signature:

Date:

STUDENT SIGNATURE: __________________________________ DATE: _____________________ Please read, sign and submit the “Memorandum of Understanding” on Page 2 of this form.

What Semester?

Fall

August – December

Spring

January – May

Summer

May - August

VA Education Benefit being used (select one)

Chapter 33 (Post-9/11 GI BILL) What Eligibility Percentage? __________%

Based On: __________________Chapter 30 (Montgomery GI Bill Active Duty)

Months Remaining: __________

Chapter 1606 (Montgomery GI Bill Selected Reserve/NG)

Months Remaining: __________

Chapter 35 (Dependents Education Assistance Program)

What is your VA File Number? __________________ Months Remaining: _______

Chapter31 (Vocational Rehabilitation and Employment)

Counselor Name: _______________ Counselor Email: _______________________________

PO Number: __________________ Start Date: End Date:

Fry Scholarship

Months Remaining: __________

Edith Nourse Rogers Science Technology Engineering Math (STEM) Scholarship

Months Remaining: __________

Months Remaining: _________

Is the student exempt from taking developmental/remedial courses?

Advisor’s

Is the student rounding out (potentially graduating) during the above term?

Yes No

Yes No

VETERAN’S CERTIFICATION REQUEST (VCR)

Memorandum of Understanding RESPONSIBILITIES OF THE VETERAN STUDENT CHAPTERS 30, 31, 33, 35, 1606 AND1607:

I understand that I must adhere to the certification rules established by Palm Beach State College and all requirements of Veteran’s Affairs to use the Montgomery GI Bill (Chapters 30, 32, 33, 35, 1606 and 1607) or VA Vocational Rehabilitation (Chapter 31) at Palm Beach State College. I am responsible for reading the information provided by Palm Beach State College (school catalog/student handbook) and following up if I do not understand the information provided. I understand that it is my responsibility to read and adhere to the Veteran’s Standards of Academic Progress as identified in the school catalog/student handbook.

It is my responsibility to complete a Veteran’s Certification Request each time I wish to use GI Bill benefits or Chapter 31 benefits. I will consult with an academic advisor each semester and request that he/she sign the form after I register for classes (exceptions: criminal justice academies/fire academy/transient students). The only classes I will be certified for are classes that are required to complete my stated program objective. I will allow 2-3 weeks (longer for initial applications or during peak times) for the Certifying Official to process this paperwork. If I am a Chapter 31 student, I understand that I must be approved by Vocational Rehabilitation and Employment (VR&E) and be provided a PO number by my counselor to ensure I am eligible to be certified. If I am a Chapter 30/33/35/1606 student, I understand that the VA may take up to 90 days (or longer) to process initial applications and up to 8 weeks (or longer) for students who have used their benefits before. If I am using Chapter 31 benefits, I understand that I must consult with and receive permission from my Vocational Rehabilitation Counselor to change my program objective.

I understand that I am entitled to one deferment of tuition and fees per academic year (Fall, Spring or Summer term). This does not include any costs associated with testing, background checks, licensing fees, equipment, books, or any fees assessed before acceptance into the college/program of study. I understand that I am not guaranteed payment by the VA before the deferment due date, and I must pay the school even if I have not received a benefits check. I understand that completing a deferment form only serves to process the deferment of tuition and fees, It does not replace the Request for Certification. I understand that my benefits checks will never be sent directly to the college to pay for tuition and fees (except Chapter 33 AND Chapter 31) and it is my sole responsibility to pay for tuition and fees.

If I withdraw, audit or drop a class, I will notify the Certifying Official at the school immediately.

If I am a non-college degree (NCD) seeking student, I will have my instructors complete an attendance sheet every month. I will ensure that this sheet is delivered to the Veteran Success Center by the 5th of the following month. I understand I must provide an attendance sheet for every class each month I attend if I am in an NCD program. I realize that sheets signed before the last day of the month will not be accepted.

I recognize the it is my responsibility to request my JST or CCAF Military Transcripts. I also understand that by signing this form I agree to allow Palm Beach State College to request my JST Transcripts. I have read and understand the above responsibilities and agree to comply to receive VA Educational Benefits at Palm Beach State College.

The completion of this form authorizes the Veterans Certification Department to certify my enrollment and provide academic record information to the Department of Veteran Affairs to ensure the receipt of Educational Training Benefits. I understand that I must complete this form each semester to receive benefits. It is my responsibility to notify the Veterans Certification Department immediately upon adding, dropping or withdrawing from a course. Palm Beach State VA Office (Lake Worth): 561-868-3380.

______________________________________________________________Signature

_______________________________________________ Date Rev. 03/30/2020 (2 of 2 pages)

NOTE: Choose "Default email application (Microsoft Outlook)", after clicking "Submit VCR to Advisor". Once email is sent, please close this PDF, as your submission is complete.

Select Your Veteran Academic Advisor: NOTE: If your having trouble or don't see your academic advisor, please reference VCR guide.