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REGIONAL CATHOLIC SCHOOL 2477 Trenton Road Levittown, PA 19056.1486 2152699600 (p).215269 9609 www.hfrcs.org horns.org FAMILY ENROLLMENT FORM 20152016 Please complete and return this Family Enrollment
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How to fill out 2015-2016 family-re-enrollment form:

01
Start by carefully reading the instructions provided on the form. Make sure you understand all the requirements and information needed to fill it out accurately.
02
Begin filling out the form by providing the requested personal information for each family member, including their full name, date of birth, and social security number.
03
If applicable, indicate any changes in contact information or address since the last enrollment.
04
Provide the necessary details regarding your family's income and financial information. This may include reporting your annual income, employment status, and any government assistance or benefits received.
05
Indicate the type of health insurance coverage you are seeking or currently have. Specify whether it is for an individual or a family, and provide any relevant policy numbers or identification information.
06
If there are other individuals in your family that are covered under a different insurance plan, note their information as well.
07
Sign and date the form to confirm that the information provided is accurate and complete.

Who needs the 2015-2016 family-re-enrollment form:

01
Families who were previously enrolled in a health insurance plan for the 2015-2016 period and wish to renew their coverage for the upcoming period.
02
Families who experienced changes in their income, employment status, or family composition and need to update their information for the 2015-2016 coverage.
03
Individuals or families who did not have health insurance coverage during the previous period and wish to enroll for the 2015-2016 period.
It is important to note that the specific eligibility requirements and availability of the 2015-2016 family-re-enrollment form may vary depending on the regulations and guidelines set by the respective health insurance provider or government program.
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Family re-enrollment form is a document used to update and confirm the enrollment status of family members in a program or service.
All members of a family or household who are enrolled in a particular program or service are required to file the family re-enrollment form.
Family re-enrollment form can be filled out by providing all required personal information, updating any changes in family composition, and signing the form to confirm enrollment status.
The purpose of family re-enrollment form is to ensure accurate and up-to-date information about the enrollment status of family members in a particular program or service.
Family re-enrollment form typically requires information such as names of family members, contact information, changes in family composition, and signatures to confirm enrollment.
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