Request For Benefits 

Request For Benefits (RFB)

Students planning to use VA benefits must complete the Request for Benefits form. This agreement must be completed each semester. The School Certifying Official (SCO) will not certify your educational benefits without a submitted RFB. Return both pages of the completed RFB form to: Vbenette@baypath.edu

Term Information


you must submit an RFB for each term

Personal Information





Military Affiliation

Benefit to be Used (This Term)



Ch. 30 (MGIB) Information

Ch. 31 (VR&E) Information



Ch. 33 (Post 9/11) Information




Ch. 35 (DEA) Information


Program Information



Example: Communications (Organizational, Interpersonal, etc.), Art Studio (Ceramics, Illustration, etc.).



Minors must be required by your major, and may not qualify for benefits. Military Science, Naval Science, etc., list them here.




Student Responsibility Agreement

Please read the following guidelines carefully. Signing below reflects your acknowledgment and receipt of these guidelines. Please keep a copy for your records.

  • I understand that VA benefits are certified on a semester basis. I must provide a new Request for Benefits each semester.
  • I understand that I must contact the School Certifying Official if there are any changes to my funding, class schedule, add/drops, failing grades, changes to my major, or withdrawal from the university. Failure to do so may result in overpayment of benefits.
  • I understand that non-standard terms must be calculated separately from a standard term, which may affect my Rate of Pursuit (FT/PT status) and, subsequently, my housing or stipend payments.
  • I understand that breaks/vacation days greater than 7 consecutive days and identified as holidays in the academic calendar (e.g., Spring break) must be reported as "vacation periods" to the VA and may impact VA stipend payments.
  • I understand that my courses must be part of my degree plan, count as prerequisites for my program, or are required for a higher-level educational program, as listed in the University catalog. I am responsible for funding courses outside of my degree plan.
  • I am responsible for the tuition and fees for classes added or dropped after the posted Add/Drop dates. Furthermore, if I drop, withdraw, or stop attending a class, I am responsible for any overpayment to the VA and/or the University of Utah.
  • If I take classes and the VA does not approve my application for benefits, then I am responsible for the payment of those classes.
  • I understand that the VA will not pay to repeat a class that has successfully been completed unless I fail a class or require a higher grade than the one achieved. I will notify the SCO before repeating a class.
  • If I receive a punitive/failing grade because I fail to attend and participate in class(es), I will be responsible for the tuition and fees of the class. The VA may seek repayment of BAH, tuition, and fees.
  • I understand that the University is required to review and report my academic status to the VA during the semester, as well as maintain a copy of my VA files, class schedule, record of academic progress, program pursuit, etc.
  • Transfer Students/Change of Major: If I am transferring from another school (or change my major), I am required to notify the School Certifying Official (SCO) prior to beginning classes.
  • Chapter 33 (Post-9/11) students: I understand I may not use any combination of benefits that will result in a surplus of funds designated for tuition and fees. The VA will be the last payer. All other educational funds (e.g., scholarships, non-title IV funds, STA, etc.) will pay first, and any remaining money due will be paid by the VA, based on my benefit tier level.
  • Chapter 33 (Post-9/11) students: If I am only eligible for any percentage under the 100% tier level, the remainder of tuition and fees is my responsibility. I may see a balance on my account and may receive occasional notifications until the VA provides payment to the school.

In accordance with the Family Educational Rights and Privacy Act (FERPA), we will not be able to release any information regarding your VA benefits or educational record to you or anyone else via phone or email. You can authorize us to talk to you or someone else by filling out the FERPA consent release online through the Campus Information System (CIS). Without this, we will only release information to you, and you will need to come in with a picture ID.

Acknowledgement of Terms