Barton Community College
Enrollment Certification Request
Great Bend Campus (800) 722-6842
Fort Riley Campus (785) 784-6606 or (877) 620-6606
Chapter 31 (Voc-Rehab) Only - VA Counselor's Name:
VA Counselor's Address (City, State):
14. *Declared Major at Barton Community College:
Please Select One
If you are NOT pursuing a degree at Barton Community College, name your *Primary School where you are currently earning your degree:
(School, City, State)
You will be required to provide a *Parent School letter from the school listed above.
16. *List the Courses you are taking this semester.
(list only Courses that apply toward the Degree program you listed in item 12.)
Office Use Only:
(signature provides approval of course selection)
To help keep spammers from using our forms you will have to type Barton below before submitting