NOTE: All items not mentioned are considered self-explanatory.
Item 2 - Enter the VA FILE NUMBER: This is usually the veteran's claim number or social security number.
Item 2 - If the claimant is receiving CHAPTER 35 benefits, enter his or her suffix. (This is a letter (A, B, etc.) designation.) For transferability cases, enter the veteran's social security number.
Item 4 - If the claimant is receiving benefits transferred to him or her, enter the claimant's SOCIAL SECURITY NUMBER.
Item 5 - DATES OF TERM AFFECTED: Enter the begin and end dates for the term in which the change in student status occurred.
Item 6A - LAST DATE OF ATTENDANCE: Enter the actual last date of attendance. For college level courses, you may use one of the following methods to determine the last date of attendance: (1) attendance records; (2) grading reports; (3) last date on which examination or other papers filed; (4) last day of activity in the instructor's records; or (5) a statement from the student as to the last day of his or her attendance
Item 6B - REASON FOR TERMINATION: (Check the appropriate box.)
WITHDRAWAL DURING DROP PERIOD: Check this box for withdrawals during an officially designated drop period of not more than 30 days. Do not use this box for withdrawals after the drop period of more than 30 days after the start of the term, whichever is earlier.
WITHDRAWAL AFTER DROP PERIOD - NONPUNITIVE GRADE ASSIGNED: A nonpunitive grade is any grade not used to compute graduation requirements. A nonpunitive grade is the equivalent of an audited course for purposes of advancement toward graduation. Typical examples are "W" (withdrawal) and "NC" (no credit). Complete Item 9 & 11.
WITHDRAWAL AFTER DROP PERIOD - PUNITIVE GRADE ASSIGNED: A punitive grade is one assigned a value when computing graduation requirements. A common example is an "F" (failing) grade which has a quality point value of "zero."
UNSATISFACTORY ATTENDANCE, CONDUCT, OR PROGRESS: Check this box for failure to meet the school's standards of attendance, conduct, or progress. In Item 6A, show the last date attendance, conduct, or progress was satisfactory.
OTHER (Explain in Item 12, Remarks): Check this box for any termination reason not shown.
WITHDRAWAL OR INTERRUPTION (Noncollege Degree Programs (NCD)): "Noncollege Degree Programs" refers to programs such as diploma or certificate programs that do not lead to a standard college degree. Check this box if a student terminates or interrupts a noncollege degree program that is not offered on a term, quarter, or semester basis. (The program may be offered on a block, unit, or clock basis.) For such programs, report in Item 12, Remarks, the first date from which no credit accrued toward graduation.
If the nondegree program is offered on a term, quarter, or semester basis, check the most appropriate of the remaining boxes.
Item 6C - LAST DATE CREDIT ACCRUED (For NCD Only): For NCD programs operating on a block, unit, or clock basis, enter the last date the student accrued credit toward graduation.
Item 7B - TYPE OF ADJUSTMENT:
INCREASE: Check this box to show an increase in credit hours, clock hours, or high school units.
REDUCTION DURING DROP PERIOD: Check this box for reductions during an officially designated drop-add period of not more than 30 days.
REDUCTION AFTER DROP PERIOD - NONPUNITIVE GRADE ASSIGNED: See Instruction Item 6B for a definition of "nonpunitive." Complete Items 9 & 11.
REDUCTION AFTER DROP-ADD PERIOD - PUNITIVE GRADE ASSIGNED: See Instructions Item 6B for a definition of "punitive."
STUDENT COMPLETED TERM BUT NONPUNITIVE GRADES ASSIGNED FOR ONE OR MORE COURSES: Check this box if a student completed a term but received nonpunitive grades for one or more courses. EXAMPLE: A student completes 12 credits and receives "W" grades for 6 credits. Enter the last day of the term in Item 7A. Enter 12 in Item 7C and 6 in Item 7D.
REDUCTION (Noncollege Degree Programs) "Noncollege Degree Programs": refers to programs such as diploma or certificate programs that do not lead to a standard college degree. Check this box if a student reduces his or her course load in a noncollege degree program that is not offered on a term, quarter, or semester basis. (The program may be offered on a block, unit, or clock basis.) For such programs, report in Item 12, Remarks, the first date from which no credit accrued toward graduation.
If the nondegree program is offered on a term, quarter, or semester basis, do not check this box. Check the most appropriate of the remaining boxes.
OTHER (Explain in Item 12 Remarks): Check this box for any
adjustment type not shown. EXAMPLES: (a) Incomplete "I" grade(s) not converted to credit grade(s) within one calendar year, or (b) Incomplete "I" grade converted to credit grade(s) or to punitive, failing grade(s).
Items 7C and 7D - CREDIT HOURS: Show a breakdown of credit hours as shown on VA Form 22-1999, Enrollment Certification, if necessary. If the student is taking noncredit, remedial, deficiency, or independent study courses, show these hours in addition to the credit hours.
EXAMPLE: |
|
Before Adjustment |
After Adjustment |
6 credit hours |
3 credit hours |
+ |
+ |
3 deficiency hours |
3 deficiency hours |
Item 8 - CHARGES FOR PERIOD OF ENROLLMENT: When required report the customer charges for the ADJUSTED load only. EXAMPLE: A student starts a term at full time, but reduces to less than half-time in the third week.
Item 9 - PREVIOUS CERTIFICATIONS FOR SUBSEQUENT TERMS: Check "yes" if there are terms, previously certified, which follow the term of the termination or adjustment and are not affected by the termination or adjustment. Check "no" if there are terms, previously certified, which follow the term of the termination or adjustment and are no longer valid.
Item 10 - CALLUP TO ACTIVE DUTY: If the termination or adjustment occurs because the student has been called to active duty, please indicate whether credit has been granted for interrupted coursework by checking the appropriate box.
Item 11 - MITIGATING CIRCUMSTANCES: These are unavoid- able or unexpected events that directly interfere with a student's pursuit of a course and are beyond the student's control. Students must submit corroborative evidence to substantiate their reasons for being unable to complete a course or courses, or receiving a nonpunitive grade.
Item 12 - REMARKS: Use this space to provide any needed clarification. It is important to clarify the student's status for terms after the one in which a change occurred. EXAMPLE: A student certified for the entire school year withdraws during the fall term. If the student is still enrolled for the spring term, enter that information in Item 12, "Remarks."
Item 13C - NAME AND ADDRESS OF SCHOOL OR TRAINING ESTABLISHMENT (Include facility code): Enter the complete name and address of the school or training establishment and the facility code. Facility codes contain 8 numbers which identify a particular school or training establishment. If you do not know your facility code, contact the VA Education Liaison Representative. Entering the facility code will help VA to be sure that your school is properly shown in the student's record.