Form 22-0976 APPLICATION FOR APPROVAL OF A PROGRAM IN A FOREIGN COUNT

OMB Approved No. 2900-0853
Respondent Burden: 20 Minutes
Expiration Date: XXXXXX

APPLICATION FOR APPROVAL OF A PROGRAM
IN A FOREIGN COUNTRY
PART I - GENERAL INFORMATION
1. TELL US WHY YOU ARE SUBMITTING THIS APPLICATION (You may check more than one box.)
INITIAL APPLICATION. This is a request for an initial approval to be designated as an institution with programs eligible for participation in VA GI Bill ® benefit
programs.
APPROVAL OF NEW PROGRAM(S). This is a request for additional programs to be approved and added to a current, active GI Bill Approval.
REAPPROVALS. This is a request for a full reapproval of currently approved GI Bill program. Program reapprovals are required every 24 months.
UPDATE INFORMATION. The purpose of this application is to update information about the institution. If "update information" is checked, please identify at
least one purpose below. This may include issues such as changes of address, banking information, etc.

OTHER. (Specify)
2A. THE INSTITUTION IS CLASSIFIED AS:

PUBLIC

PRIVATE-FOR-PROFIT

PRIVATE-NOT-FOR-PROFIT

2B. DOES YOUR COUNTRY'S GOVERNING AUTHORITY, WITH OVERSIGHT OVER EDUCATIONAL INSTITUTIONS AND PROGRAMS, OFFICIALLY CLASSIFY THE
FACILITY AS A INSTITUTION OF HIGHER LEARNING? (i.e., as a college, university, or similar establishment offering postsecondary level academic instruction leading to the
conferring of a degree.)
YES
NO (If "YES," what type of degree(s)?)
3B. VA FACILITY CODE (If known)

3A. NAME OF INSTITUTION

4B. B. MAILING ADDRESS

4A. PHYSICAL ADDRESS

4C. COUNTRY

5. INSTITUTION WEBSITE ADDRESS

PART II - DEGREE PROGRAMS
6. PLEASE PROVIDE THE FOLLOWING INFORMATION FOR THE EDUCATIONAL PROGRAMS THAT YOU ARE REQUESTING TO BE APPROVED FOR GI BILL
BENEFITS.

NAME OF DEGREE
PROGRAM
(i.e. AS Business
Administration, BS Information
Technology)

TOTAL LENGTH OF
PROGRAM
(i.e. 2 year, 3 year program)

NUMBER OF WEEKS PER
TERM/SEMESTER

ENTRY REQUIREMENTS

NUMBER OF
CREDIT HOURS

Check here if you are requesting approval for more than 4 programs and continue on a separate sheet(s). Please annotate each sheet to read, for example, 1 of 3,
2 of 3 etc., and attach the separate sheet(s) to the approval package.

PART III - SCHOOL CERTIFICATION AND ACKNOWLEDGEMENTS
7. THE FOLLOWING ARE REQUIREMENTS FOR PARTICIPATION. VA MUST BE ABLE TO VERIFY THE FOLLOWING INFORMATION USING THE SUBMITTED
DOCUMENTATION OR OTHER PUBLISHED INFORMATION.
• The institution has adequate available space, the appropriate facilities and equipment to conduct the programs for which it seeks approval.
• The institution has a calendar showing holidays, closings, beginning and end-dates of each quarter, term or semester, and other important dates, such as exam
periods.
• The institution has documented policies relative to the refund of the unused portion of a tuition, fees, and other charges in the event a student withdraws or
discontinues their enrollment.
Authorizing Official
Initial Here
VA FORM
XXXX

22-0976

SUPERSEDES VA FORM 22-0976, OCT 2020,
WHICH WILL NOT BE USED.

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PART III - SCHOOL CERTIFICATION AND ACKNOWLEDGEMENTS (CONTINUED)
8. THE INSTITUTION MUST RETAIN THE RECORDS AND ACCOUNT INFORMATION OF VA STUDENTS FOR THREE YEARS FOLLOWING THE ENDING DATE OF
THE LAST PERIOD OF ATTENDANCE CERTIFIED TO VA. THE INSTITUTION MUST MAKE THESE RECORDS AVAILABLE FOR VA INSPECTION UPON REQUEST
FOR THE PURPOSE OF VERIFICATION OF COMPLIANCE WITH THE FOLLOWING PROGRAM REQUIREMENTS:
• Maintain sufficient records to show the progress of each VA student and to promptly inform VA when the conduct or progress of any VA student is not
satisfactory in accordance with the regularly prescribed standards and practices of the institution.
• Institution will give appropriate credit for previous education and training of VA students and shorten the training program appropriately.
• Institution will only certify to VA, courses that are required for the completion of the student's degree program.
• Institution will charge both VA and Non-VA students the same tuition, fees and other related miscellaneous amounts for the costs of attendance.
• Institution will agree to promptly inform the VA when it comes to the school's attention that any VA student:
o
o
o
o

Has changes in hours of credit or attendance, or
Has interrupted or discontinued a course or program of study, giving the date(s) of withdrawal, and the reason(s), if known, or
Completed/graduated from the program, or
Receives grade(s) for any course(s) that will not be used when computing graduation requirements.

Authorizing Official
Initial Here
9. INSTITUTION UNDERSTANDS THE FOLLOWING IMPORTANT PROGRAM REQUIREMENTS AND/OR LIMITATIONS:
• Institution will be financially responsible to VA for the payments made directly to the educational institution pursuant to the Post-9/11 GI Bill, and the Yellow
Ribbon GI Bill Educational Enhancement Program.
• Institution will not impose any penalty, including the assessment of late fees, the denial of access to classes, or other institutional facilities, or require that VA
students borrow funds due to VA-delayed disbursement of funding.
• Institution will not engage in advertising and/or enrollment practices of any type, which are erroneous, deceptive, or misleading either by actual statement,
omission or intimation.
• Institutions are prohibited from using "GI Bill" in any manner that directly or indirectly implies a relationship affiliation, or endorsement affiliation with the
Department of Veterans Affairs.
• Institution must select an employee to act as a VA contact person (School Certifying Official) and will complete a new VA Form 22-8794, Designation of
Certifying Official, whenever a new employee is selected to perform this role.
• Institution agrees to adhere to the VA GI Bill Trademark Terms of Use. Please click this link for information regarding the Terms of Use.
Trademark Terms of Use - Education and Training (va.gov).
• Institution agrees to submit all enrollment certifications and any amendments, adjustments, or terminations electronically through the VA Online Certification
Enrollment (VA-ONCE system. VA-ONCE Student LOGIN PAGE (U.S. Department of Veterans Affairs)
Authorizing Official
Initial Here
10. INSTITUTIONS THAT PARTICIPATE IN VA GI BILL PROGRAMS MUST AGREE TO ELECTRONIC FUNDS TRANSFER (EFT) - DIRECT DEPOSIT
TRANSACTIONS FOR THE PAYMENT OF FUNDS OWED TO THE INSTITUTION.
Authorizing Official
Initial Here
NOTE: VA will contact the institution to make arrangements to set up electronic funds transfer (EFT) - Direct Deposit or International Direct Deposit Arrangement.
11. BRANCHES: PLEASE LIST OTHER OFF-CAMPUS LOCATIONS, INCLUDING COMPLETE MAILING ADDRESS FOR EACH OFF-CAMPUS LOCATION WITHIN
SAME COUNTRY.

BRANCH

COMPLETE ADDRESS

IF MORE THAN 4 BRANCHES, PLEASE ATTACH A COPY OF THE COMPLETE LIST OF BRANCHES WITH YOUR APPLICATION. PLEASE EMAIL
[email protected] FOR ANY ADDITIONAL QUESTIONS.
VA FORM 22-0976, XXXX

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12. LIST OF SCHOOL GOVERNING BODY, OFFICIALS AND FACULTY. (Please attach a separate sheet if you would like to list additional names.)

OFFICIALS AND FACULTY

TITLE

PART IV - MEDICAL SCHOOL INFORMATION ONLY
13. INSTITUTION IS LISTED AS A MEDICAL SCHOOL IN THE WORLD DIRECTORY OF MEDICAL SCHOOLS PUBLISHED BY THE WORLD HEALTH ORGANIZATION.
YES

NO

14. THE NAME OF THE ACCREDITING AUTHORITY OPERATING IN YOUR COUNTRY THAT RECOGNIZES THE INSTITUTION AS A MEDICAL SCHOOL.

15. INSTITUTION PROVIDES (and requires its students to complete), A PROGRAM OF CLINICAL AND CLASSROOM INSTRUCTION THAT IS AT LEAST 32 MONTHS
IN LENGTH.
YES

NO

16. INSTITUTION GRADUATED CLASSES DURING EACH OF THE LAST TWO 12-MONTH PERIODS.
YES

NO

(If "YES," include the date (month, day, year) of the last two graduating classes and the number of students that graduated in each class.)
DATE OF GRADUATING CLASS

NUMBER OF STUDENTS THAT GRADUATED

DATE OF GRADUATING CLASS

NUMBER OF STUDENTS THAT GRADUATED

PART V - INSTITUTION CONTACTS
17A. NAME OF SCHOOL FINANCIAL REPRESENTATIVE

17B. SCHOOL FINANCIAL REPRESENTATIVE EMAIL ADDRESS

18A. NAME OF SCHOOL CERTIFYING OFFICIAL (No signature for original
applications)

18B. SCHOOL CERTIFYING OFFICIAL EMAIL ADDRESS

PART VI - CERTIFICATION AND SIGNATURE OF AUTHORIZING OFFICIAL
I CERTIFY THAT all statements in this application are true and correct to the best of my knowledge and belief.
19A. NAME OF AUTHORIZING OFFICIAL

19B. SIGNATURE OF AUTHORIZING OFFICIAL

19C. DATE SIGNED

PRIVACY ACT INFORMATION: VA will not disclose information collected on this form to any sources other than what has been authorized under the Privacy Act of 1974 or Title
38, Code of Federal Regulations, Section 1.526 for routine uses (e.g. VA sends education 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 the VA to obtain further information as may be necessary from the school for the 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 obligation to respond is required to obtain or retain education benefits. The
requested information is considered relevant and necessary to determine the maximum benefits under the law. While you do not have to respond, VA cannot process your claim for
education assistance unless the information is furnished as required by existing law (38 U.S.C. 3471). 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 your continued eligibility to VA education benefits (38 U.S.C. 3471). Title 38, United States Code, allows us to ask
for this information. We estimate that you will need an average of 20 minutes 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 http://www.reginfo.gov/public/do/PRAMain.
VA FORM 22-0976, XXXX

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INSTRUCTIONS AND INFORMATION PAGE

Line Items 7 - 10
In order for a program to be approved, line items 7 - 10 must be initialed by the institution authorizing official
acknowledging agreement and compliance with the requirements. If the school is unable to agree to EFT requirements,
programs will not be approved for VA benefits.
Line Items 11 - 12
These sections must be completed in its entirety. Attach additional sheets if necessary.
Line Items 13 - 16
These questions only need to be completed by medical schools. If the institution is not a medical school, you can disregard
these questions.
IF YOU NEED HELP
If you need help in completing this form, you can contact the VA at: [email protected].
TO FILE THIS FORM:
Please email the form to [email protected]. No need to send a hard copy application via U.S. mail.

VA FORM 22-0976, XXXX

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