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THE NEW SCHOOL 2014-2015 STUDENT HEALTH INSURANCE PLAN DEPENDENT ENROLLMENT FORM You may enroll your eligible dependents in the plan ONLY if you are enrolled in the plan yourself. If enrolling a new
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How to fill out "you may enroll your":

01
Start by accessing the enrollment form online or obtaining a physical copy from the concerned institution or organization.
02
Carefully read through the instructions provided on the form to ensure you understand the requirements and any supporting documentation needed.
03
Begin by providing your personal information, such as your full name, date of birth, contact details, and address. Ensure accuracy and double-check for any errors or misspellings.
04
Depending on the purpose of enrollment, you may be required to indicate the grade level, course, or program you wish to enroll in. Provide this information accordingly.
05
If applicable, provide any additional information or preferences that may be required, such as selecting a specific start date or campus location.
06
Review the form thoroughly before submitting. Check for any missing fields or information and make any necessary corrections.
07
If required, attach any supporting documents, such as identification proof, previous academic transcripts, or proof of residence. Ensure that these documents are properly labeled and attached securely.

Who needs to enroll:

01
Students: If you are a student wishing to join a school or educational institution, you may need to fill out the enrollment form to officially become a student.
02
Employees: In some cases, employees may be required to complete an enrollment form to enroll in employee benefit programs, such as health insurance or retirement plans.
03
Members: Various organizations, clubs, or associations may require individuals to enroll as members to access their services or participate in their activities.
Remember, the specific requirements for enrollment may vary depending on the institution, organization, or context. It is important to carefully read and follow the instructions provided on the enrollment form or reach out to the relevant authorities for clarification if needed.
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You may enroll in a health insurance plan.
Individuals who are eligible for health insurance coverage.
You can fill out the enrollment form online or by mail.
The purpose of enrolling in a health insurance plan is to have coverage for medical expenses.
Personal information, income, and any dependents who will also be covered.
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