Semester VA Certification Form

Semester VA Certification Request

Merrimack College students using VA education benefits must submit a Semester Confirmation Form through their myMack at the start of each semester. Benefits will not be processed if the request is not received.

First Name

Last Name

Merrimack ID

Email Address

Which semester are you now requesting VA certification?

What is your benefit level?

Please Explain:

Will you be registered for an internship or co-op this semester?

Yes

No

How many hours per week will you be working in your internship?

I understand that it is my responsibility to be aware of my benefit payments and will pay any outstanding balance that is owed to Merrimack College.

I authorize Merrimack College to submit an enrollment certification on my behalf for the above term.

Electronic Signature

Today's Date

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Semester VA Certification Form