Form 0918a Certification of National Paralympics & Olympics Trainin

OMB Number: 2900-0760
Exp. Date: July 31, 2024
Respondent Burden: 5 minutes

CERTIFICATION OF NATIONAL PARALYMPICS AND OLYMPICS TRAINING STATUS
PRIVACY ACT: The information requested on this form is solicited under the authority of Title 38, U.S.C., and Sections 1710, 1712, and 1722. It is being collected to
enable us to determine your eligibility for benefits and will be used for that purpose. The information you supply may be verified through a computer matching program at
any time and information may be disclosed outside the VA as permitted by law. VA may make a routine use disclosure of the information as outlined in the Privacy Act
system of records identified as 58VA21/22/28, Compensation, Pension, Education and Vocational Rehabilitation and Employment Records - VA, published in the Federal
Register. Your obligation to respond is voluntary; however, the information is required in order for us to determine your eligibility for the benefit for which you have
applied. Failure to furnish the information will have no adverse affect on any other benefits to which you may be entitled.
VA BURDEN STATEMENT: An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a
currently valid OMB control number. The OMB control number for this project is 2900-0760, and it expires 07/31/2024. Public reporting burden for this collection of
information is estimated to average 5 minutes per respondent, per year, including the time for reviewing instructions, searching existing data sources, gathering and
maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate and any other aspect of this
collection of information, including suggestions for reducing the burden, to VA Reports Clearance Officer at VACOPaperworkReduAct@va.gov. Please refer to OMB
Control No. 2900-0760 in any correspondence. Do not send your completed VA Form 0918a to this email address.

SECTION A - IDENTIFYING DATA
1. NAME AND MAILING ADDRESS OF APPLICANT

2. LEVEL

.

.

EMERGING
NATIONAL TEAM ATHLETE
3. DISABILITY CLASSIFICATION

SERVICE-CONNECTED
NONSERVICE-CONNECTED

SECTION B - CERTIFICATION OF TRAINING STATUS
4A. NAME OF SPORT

5A. DATE STANDARD MET
(Current FY; MM/DD/YYYY)

4B. SPORT CLASSIFICATION

5B. EVENT/COMPETITION/CAMP STANDARD MET
NAME AND LOCATION

5C. SCORE/TIME/JUSTIFICATION

SECTION C - PERIOD OF ENROLLMENT
6A. BEGINNING
DATE

6B. ENDING
DATE

6C. TYPE OF TRAINING
(Select all that Apply)
TRAINING

COMPETITION

RESIDENCE

TRAINING

COMPETITION

RESIDENCE

TRAINING

COMPETITION

RESIDENCE

TRAINING

COMPETITION

RESIDENCE

SECTION D - CERTIFICATION OF ATTENDANCE AND STATUS
(Applicants must be invited to participate in Paralympics or Olympics training by the applicable
governing Paralympics or Olympics sport entity to receive a VA allowance)
7. I certify that the individual in Item 1 began or resumed the training program listed in Section B for the period specified under
Section C. Furthermore, I certify that I will notify the Department of Veterans Affairs, Office of National Veterans Sports Programs
and Special Events, within 3 working days of a change in the individual's training status.
8A. NAME, TITLE, AND SIGNATURE OF DESIGNATED CERTIFYING OFFICIAL

8B. DATE SIGNED

SECTION E - CERTIFICATION OF MARITAL AND DEPENDENT STATUS
9. I certify that information submitted on my application, VA Form 0918b, regarding my marital and dependent status is current and
valid. Furthermore, I certify that I will notify the Department of Veterans Affairs, Office of National Veterans Sports Programs and
Special Events, within 14 business days of a change in my marital or dependent status.
10A. PRINTED NAME AND SIGNATURE OF VETERAN

VA FORM
JUL 2024

0918a

10B. DATE SIGNED