VA Semester Worksheet Form :: Dakota College at Bottineau

This form must be filled out for each term of enrollment. Failure to complete this form fully will cause a delay in processing your enrollment verification & monthly GI benefits.

Term *

Student ID # *

First Name *

Last 4 of your VA file number *

Last Name *

Address *

State *

City *

Zip Code *

Email Address *

Confirm Email Address *

Phone Number *

I consent to the release to the US Department of Veterans Affairs all of my educational records maintained by Dakota College at Bottineau, including my Social Security Number to allow me to receive VA educational benefits.

Check this box if you agree

Are you a *

What benefit chapter are you using? *

Are you using TA in addition to the GI Bill? *

What % do you qualify for your benefit? (enter 0 if you don't know) *

Remaining months of benefits? (Enter 0 if you don't know) *

Major *

Are you a *

If this is your first term transferring to Dakota College you are required to complete additional paperwork at this link. If you need additional information please contact our military office.

Number of credits enrolled this semester? *

Changes made to your schedule after submitting this form need to be reported to the Dakota College military office. Your changes may create a debt for you that will require repayment of VA educational benefits you may have already received (book stipend, housing, tuition and fees).

Are you repeating any courses (Enter 0 if no, list repeated courses if yes)? *

Are you using tuition waivers (enter 0 if no, list waivers below if yes)? *

Are you taking collaborative courses (enter 0 if no, list course and school if yes)? *

Are you receiving scholarship(s) (enter 0 if no, list scholarship(s) if yes)? *

Your instructor will be contacted if you receive a failing grade. It is important to understand that the VA pays you for attending class, not just registering for the course(s).

Check this box if you agree

The VA WILL NOT pay for repeated courses (unless the course you are repeating requires a higher grade than you received initially).

Check this box if you agree

The VA WILL NOT PAY FOR AUDITED COURSES.

Check this box if you agree

Chapter 30, 1606, 1607 recipients must verify their enrollment monthly (online via W.A.V.E. or by phone).

Check this box if you agree

FAILURE TO NOTIFY THE DAKOTA COLLEGE MILITARY OFFICE OF CHANGES TO MY SCHEDULE MAY RESULT IN AN OVERPAYMENT OF BENEFITS WHICH I WILL BE RESPONSIBLE TO PAY BACK TO THE VA.

Check this box if you agree