VA Benefits Request

  •  NOTE:

    • Please complete all items. An error or omission may delay your benefits.
    • You must be degree-seeking (in an approved program of study) to receive VA Benefits. VA regulations support registration only for those courses listed in the college catalog as necessary for the completion of the curriculum that you have declared. Only those courses, or courses required by the college as prerequisites to those courses, will be certified for payment of benefits.


    * Last Name   
    * First Name  
    * Student ID  
    *Social Security Number  
    * VA File Number (Required for Chapter 35)  
    * Program of Study  
    * Term Applying for:  
    * Date of Birth  
    *E-mail Address:  
    Check here if this is a new address.  
    * Street Address  
    * City  
    * State  
    * Zip  
    * Home Phone  
    Work Phone  
    * Are you on Active Duty?  
    will you be receiving tuition assistance for any portion of your classes?
    * Indicate the type of benefits that you will be receiving


    Name of Case Manager (Required):

    * Indicate your VA Status


    VA regulations require that all transfer students using VA benefits
    must have transcripts from previous colleges, including military transcripts, forwarded to PGCC for evaluation of transfer credit. A Request for Evaluation of Transfer Credit form must be completed to initiate the evaluation of your transcripts after all transcripts have been received. Failure to have your transcripts evaluated during your first or second semester may cause the VA to stop payment of your VA benefits. Have transcripts sent to:  



    301 LARGO ROAD
    LARGO, MD 20774 



     *Please list all courses for which you are registered this semester and for which you want to be paid benefits. 

    (Example: BIO 1010 LD01)  
    Course Ref #
    (Example: 13254)
    Course Type (for each course indicate C-DL or WK)
    C = Classroom
    DL = Distance/Blended Learning
    WK = Weekend 
    Credit Hours/CEUs

     Policies and Procedures

    1. I understand that my enrollment will not be certified to the VA until I have paid, or arranged for, my tuition. (CH. 33 veterans are considered to be paid at the time of registration up to the per cent of their eligibility.)
    2. I understand that I must complete this school form
      every semester
        to be certified to the VA. The college does not assume either your enrollment or your wish to use your benefits for a semester.
    3. Courses that meet less then 15 weeks (full-semester) are only certified for the time period during which they actually meet. They are considered a part of my course load ONLY while they are in session, not for the full semester.
    4. DLS, DVE, DVM, and DVR courses are fully certifiable
      you submit a Developmental Course Certificate of Need form, signed by a college advisor, to the College Vet. Affairs Office.
    5. All Veteran Ed. Benefit students are required to submit prior college transcripts and military training records to the college for evaluation withing the first year of attendance. Failure to do so usually results in a halt to your benefits until this is resolved. Pplease provide the documents, even if you know that nothing is going to transfer.
    6. I understand that only courses required by my program of study can be certified. (We strongly urge you to go to Owl Link and run a Program Evaluation for yourself before finalizing your VA paperwork. Courses which appear under the last heading of "Other Courses" on the evaluation cannot be certified unless they are developmental courses or college-mandated prerequisites to courses required in your program.
    7. All VA benefit recipients must notify the College VA Office immediately of all changes in course enrollment such as: ADDS, DROPS, AUDITS, OFFICIAL WITHDRAWLS, CHANGES IN PROGRAM (CURRICULUM), REENROLLMENTS, AND ADDRESS. If mitigating circumstances (unanticipated/unavoidable situations beyond your control that prevent course completion) occur, submit a completed VA Form 21-4138 (with supporting documents) to the College VA office for submission to the Department of Veterans Affairs. VA Form 21-4138 is available in B126.
    8. I agree that any information on this form or in my College file may be shared with the VA at their request.