22-8979 Student Verification Of Enrollment

OMB Approved No. 2900-0465
Respondent Burden: 1 Minute
Expiration Date: XX/XX/XXXX

STUDENT VERIFICATION OF ENROLLMENT
PLEASE READ GENERAL INFORMATION ON PAGE 2 BEFORE COMPLETING FORM
INSTRUCTIONS: You MUST complete Items 1 and 6B. Mail the completed application to the VA Regional Processing Office (RPO)
for the state or region where your school is located. See RPO addresses on page 2.

SECTION I - APPLICANT INFORMATION
1. SOCIAL SECURITY NUMBER OF APPLICANT

2. GENDER OF APPLICANT
MALE

FEMALE

3. APPLICANT'S DATE OF BIRTH
Month

Day

Year

4. NAME (First, Middle Initial, Last)

5. APPLICANT'S ADDRESS
Number and Street
Apt./Unit Number
City, State, ZIP Code
6A. APPLICANT'S TELEPHONE NUMBERS (Include Area Code)
Mobile:
Home:
6B. APPLICANT'S E-MAIL ADDRESS (Required)

SECTION II - SCHOOL INFORMATION
7. PROVIDE THE FULL NAME AND ADDRESS OF THE SCHOOL

8. TERM DATES OF ENROLLMENT (MM/DD/YYYY)
BEGIN DATE OF TERM (MM/DD/YYYY)

END DATE OF TERM (MM/DD/YYYY)

9. I WAS ENROLLED AS CERTIFIED BY MY SCHOOL SINCE THE LAST VERIFICATION

YES

NO (If "NO," complete Items 10A and 10B. Notify your school of the change)

10A. DATE OF CHANGE IN HOURS (MM/DD/YYYY)

10B. NUMBER OF HOURS AFTER CHANGE

(Notify the School Official of the Change)

11. Your school has reported that you will continue training until
(If this date is incorrect, immediately notify your school of the revised ending date)

I CERTIFY THAT the information above is true and correct to the best of my knowledge and belief.
PENALTY - Willful false reports concerning benefits payable by VA may result in a fine, imprisonment, or both.
12A. SIGNATURE OF STUDENT

VA FORM
XXX XXXX

22- 8979

12B. DATE SIGNED

SUPERSEDES VA FORM 22-8979, FEB 2020,
WHICH WILL NOT BE USED.

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GENERAL INFORMATION
IF YOU HAVE ANY QUESTIONS OR CONCERNS ABOUT THE PROPER
COMPLETION OF THIS FORM:
CALL 1-888-GIBILL-1 (1-888-442-4551) BEFORE COMPLETING THIS FORM.
FOR INFORMATION ON VERIFYING YOUR ENROLLMENT,
BY TELEPHONE OR INTERNET,
SEE OUR EDUCATION HOME PAGE (WWW.BENEFITS.VA.GOV/GIBILL)
Step 1: Complete all applicable questions in Sections I and II of the form.
Step 2: Sign and date the form in Items 12A and 12B.
Step 3: If mailing the form - place completed form in envelope and mail to the appropriate VA Regional Processing
Office (RPO) that represents the state or region where your school is located as shown below.
Step 4: If submitting the form electronically it can be sent via Email through https://ask.va.gov.
Step 5: Upon receipt of the form, VA will process your Verification of Enrollment.

Eastern Region:
VA Regional Office
P.O. Box 4616
Buffalo, NY 14240-4616
SERVES THE FOLLOWING STATES

DC

DE

IA

IL

IN

KS

KY

MA

ME

MI

MN

MO

MT

NC

ND

NE

NH

NY

OH

PA

RI

SD

TN

VA

VT

WI

CO

CT

MD
NJ
WV

WY

APO / FPO AA

FOREIGN SCHOOLS

US VIRGIN ISLANDS

Western Region:
VA Regional Office
P.O. Box 8888
Muskogee, OK 74402-8888
SERVES THE FOLLOWING STATES

AK

AL

AR

AZ

CA

FL

GA

HI

ID

LA

MS

NM

NV

OK

OR

PR

SC

TX

UT

WA

APO / FPO AP

GUAM

PHILIPPINES

AMERICAN SAMOA

MARIANA ISLANDS

PRIVACY ACT INFORMATION: VA will not disclose information collected on this form to any source other than what has been authorized under the Privacy
Act of 1974 or Title 38, Code of Federal Regulations 1.576 for routine uses (e.g., VA sends educational forms or letters with a veteran's identifying information to
the veteran's school or training establishment to (1) assist the veteran in the completion of claims forms or (2) for VA to obtain further information as may be
necessary from the school for VA to properly process the veteran's education claim or to monitor his or her progress during training) as identified in the VA system
of records, 58VA21/22/28, Compensation, Pension, Education and Veteran Readiness and Employment Records - VA, published in the Federal Register. Your
response is required to obtain or retain benefits. While you do not have to respond, payment of education benefits cannot be made unless the information is
furnished as required by existing law (38 U.S.C. 3680(g)). The responses you submit are considered confidential (38 U.S.C. 5701). Any information provided by
applicants, recipients, and others may be subject to verification through computer matching programs with other agencies.
RESPONDENT BURDEN: We need this information to determine eligibility to education benefits and the proper amount payable (38 U.S.C. 3684). Title 38,
United States Code allows us to ask for this information. We estimate that you will need an average of 1 minute to review the instructions, find the information, and
complete this form. VA cannot conduct or sponsor a collection of information unless a valid OMB control number is displayed. You are not required to respond to a
collection of information if this number is not displayed. Valid OMB control numbers can be located on the OMB Internet Page at www.reginfo.gov/public/do/
PRAMain . If desired, you can call 1-888-GI-BILL-1 (1-888-442-4551) to get information on where to send comments or suggestions about this form. (Call 711,
Federal Relay, if you use the Telecommunications Device for the Deaf (TDD)).

VA FORM 22-8979, XXX XXXX

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