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This document serves as a form for enrolling dependents in the Worcester State College Student Accident and Sickness Insurance Plan for the year 2007-2008. It includes spaces for dependent information,
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How to fill out WORCESTER STATE COLLEGE STUDENT ACCIDENT AND SICKNESS INSURANCE PLAN DEPENDENT ENROLLMENT FORM
01
Obtain the Worcester State College Student Accident and Sickness Insurance Plan Dependent Enrollment Form from the college website or student health services.
02
Fill in your personal information, including your name, student ID, and contact details in the designated sections.
03
Provide information about your dependent(s) including their full names, dates of birth, and relationship to you.
04
Select the coverage option that you wish to enroll your dependent(s) in, if applicable.
05
Review the form for any additional documentation required, such as proof of dependency or insurance eligibility.
06
Sign and date the form to certify that all information is correct.
07
Submit the completed form to the appropriate office (student health services or insurance coordinator) by the specified deadline.
Who needs WORCESTER STATE COLLEGE STUDENT ACCIDENT AND SICKNESS INSURANCE PLAN DEPENDENT ENROLLMENT FORM?
01
Students at Worcester State College who wish to enroll their dependents in the Student Accident and Sickness Insurance Plan.
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What is WORCESTER STATE COLLEGE STUDENT ACCIDENT AND SICKNESS INSURANCE PLAN DEPENDENT ENROLLMENT FORM?
The WORCESTER STATE COLLEGE STUDENT ACCIDENT AND SICKNESS INSURANCE PLAN DEPENDENT ENROLLMENT FORM is a document used by students to enroll their dependents in an insurance plan that covers accidents and sickness.
Who is required to file WORCESTER STATE COLLEGE STUDENT ACCIDENT AND SICKNESS INSURANCE PLAN DEPENDENT ENROLLMENT FORM?
Students at Worcester State College who wish to add their dependents to the student accident and sickness insurance plan are required to file this form.
How to fill out WORCESTER STATE COLLEGE STUDENT ACCIDENT AND SICKNESS INSURANCE PLAN DEPENDENT ENROLLMENT FORM?
To fill out the form, students must provide personal information about themselves and their dependents, including names, dates of birth, and insurance details. They should follow the instructions provided on the form itself.
What is the purpose of WORCESTER STATE COLLEGE STUDENT ACCIDENT AND SICKNESS INSURANCE PLAN DEPENDENT ENROLLMENT FORM?
The purpose of the form is to facilitate the enrollment of dependents in the college's accident and sickness insurance plan, ensuring that they receive medical coverage.
What information must be reported on WORCESTER STATE COLLEGE STUDENT ACCIDENT AND SICKNESS INSURANCE PLAN DEPENDENT ENROLLMENT FORM?
The form must report information such as the student's personal details, dependent's names, relationship to the student, dates of birth, and any previous insurance details if applicable.
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