This form must be submitted every semester you are enrolled or when adjusting your schedule.

  • Please complete and submit the online form below.
  • Note that your curriculum code is required to complete this form. The curriculum code is a reference number (no letters) for your degree or certificate program.

Degree and Certificate Programs at LCCC



  • Name * Required
  • Address * Required
  • (Your LCCC email address begins with the username for your MyCampus account and ends in
  • See the link above for the list of Majors
  • (4-digit number - See the link above for the list of Curriculum Codes/Majors)
  • (See the link above for the list of Majors)
  • (4-digit number - See the link above for the list of Curriculum Codes/Majors)
  • Has your major changed since last semester? * Required
  • If this is a University Partnership Program, please provide the information below

  • Your Assigned Academic Advisor can be found on your MyCampus Account
  • Courses to be Certified * Required
    Enter each course below (i.e.: Course Abbreviation and Number HLED 151 Credit Hours 3). Click the Plus Sign to add additional courses.
    Course Abbreviation and NumberCredit HoursAdd or remove row
    Add a new row
  • If you are a spouse/dependent, you will select "No Military Service"
  • GI Bill Benefit Chapter
  • If you are a new student, have you used your G.I. Benefits at another college?
    Note: If so, you will need to complete VA Form: 22-1995 Change of Program/Place of training.
  • Is this the first time you are submitting your schedule for this semester? * Required
    If you are uncertain if the courses you have registered for are required in your degree, you should consult with your counselor or advisor before requesting enrollment certification.
  • Have you made any changes to your schedule? * Required
    Note: If you stop attending class and receive a failing grade, VA will not pay for that class.
  • Are you going to graduate at the end of the semester? * Required
  • I hereby acknowledge the following and will report immediately to the VA Certifying Official at LCCC any changes in my enrollment:

    • It is my responsibility to self-verify attendance monthly through VA CERT (Ch. 33 & 35 excluded).
    • I understand that I must remain in good academic standing to be certified as outlined in the Veterans’ Standards of Progress policy stated in the LCCC Catalog.
    • I understand that all courses I am registered for must apply to my degree program and be approved by an Academic Advisor, and if I change courses after I have submitted this initial request, that I must submit a new Veteran’s Certification Request for approval for these changed courses. This does not guarantee approval.
    • I understand that if I stop attending a class, withdraw or drop classes that a debt may be incurred.
    • If I take courses in an 8 or 10 week format in a regular semester (not summer) it may impact my VA funding.
    • I understand that I must read all information on the Veteran’s Responsibility Agreement and understand my obligations about attending classes and keeping good grades.
    • I understand that the VA does not permit a course to be repeated in which I have earned a grade of D or better except in very special circumstances (Allied Health or Remedial Courses).
    • I realize that Physical Education courses will not be certified unless required by my degree program or I am a Chapter 35 (Survivor/Dependent) recipient.
    • If I change my major I must complete the appropriate paperwork (VA Form 22-1995).
    • I understand that online remedial courses (class numbers starting in zero, ex: MTHM 051) are not approved by VA. Remedial courses can only be taken on campus.
  • I confirm that I have read and acknowledge my responsibility to the above. * Required


*GI Bill® is a registered trademark of the U.S. Department of Veterans Affairs (VA). More information about education benefits offered by VA is available at the official U.S. government web site at