Get the free 2010 – 2011 Student Injury and Sickness Plan Enrollment Form for ESL Students - gonzaga

This form allows ESL students at Gonzaga University to enroll in a student insurance plan, detailing coverage options for individuals and their dependents.

How to fill out 2010 2011 student injury

How to fill out 2010 – 2011 Student Injury and Sickness Plan Enrollment Form for ESL Students

1. Obtain the 2010 – 2011 Student Injury and Sickness Plan Enrollment Form for ESL Students from your school's administrative office or website.
2. Read the instructions carefully before filling out the form to ensure you understand the requirements.
3. Fill out your personal information in the designated sections, including your full name, date of birth, and student ID number.
4. Provide your contact information such as your current address, phone number, and email address.
5. Indicate your enrollment status and the type of coverage you are applying for.
6. Complete the medical history section truthfully, providing details about any pre-existing conditions or ongoing treatments.
7. Sign and date the form to certify that all information provided is accurate and complete.
8. Submit the form to the designated office before the enrollment deadline, ensuring you have kept a copy for your records.

Who needs 2010 – 2011 Student Injury and Sickness Plan Enrollment Form for ESL Students?

1. All ESL students enrolled in academic programs who require health insurance coverage for injuries and illnesses during the 2010 – 2011 academic year.
2. International students who may not have access to other healthcare plans and need enrollment in the Student Injury and Sickness Plan.

For pdfFiller’s FAQs

What is 2010 – 2011 Student Injury and Sickness Plan Enrollment Form for ESL Students?

The 2010 – 2011 Student Injury and Sickness Plan Enrollment Form for ESL Students is a document used to enroll eligible international students in a specific health insurance plan that covers medical expenses related to injuries and sickness.

Who is required to file 2010 – 2011 Student Injury and Sickness Plan Enrollment Form for ESL Students?

All international ESL students who wish to participate in the health insurance plan must file the enrollment form.

How to fill out 2010 – 2011 Student Injury and Sickness Plan Enrollment Form for ESL Students?

To fill out the form, students need to provide personal information such as their name, student ID, contact details, and course information, along with any relevant health information as required by the form.

What is the purpose of 2010 – 2011 Student Injury and Sickness Plan Enrollment Form for ESL Students?

The purpose of the form is to ensure that ESL students have adequate health insurance coverage for injuries and illnesses that may occur during their studies.

What information must be reported on 2010 – 2011 Student Injury and Sickness Plan Enrollment Form for ESL Students?

Students must report their personal identification information, contact details, enrollment status, course details, and any prior health insurance information as specified in the form.