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USE BLACK INK ONLY. PLEASE PRINT. For address and×or primary care physician changes call (518× 6413100, 18777242579, or visit www.cdphp.com Enrollment Application/ Change Form EMPLOYER USE ONLY
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How to fill out enrollment application change form?

01
Obtain the form: Start by acquiring the enrollment application change form from the relevant institution or organization. You can usually find this form on the institution's website or by requesting it from their office.
02
Read the instructions: Carefully read the instructions provided with the form. These instructions will guide you on how to accurately complete the form and ensure that you provide all the necessary information.
03
Fill in personal information: Begin by filling out your personal information, such as your full name, date of birth, contact information, and any other details requested. Make sure to write legibly and use black ink to complete the form.
04
Provide student details: If the enrollment application change form is for a student, you will need to provide their information as well. Include their full name, student ID or enrollment number, and any other relevant details required.
05
Specify the changes: In the appropriate section of the form, clearly state the changes you wish to make to your enrollment. This could include changing your program, adding or dropping courses, or updating personal information. Be specific and provide any necessary supporting documentation if required.
06
Review and sign: Once you have filled out all the necessary sections of the form, carefully review the information you have provided to ensure accuracy. Double-check your contact details and any changes you have requested. Finally, sign and date the form to attest to the accuracy of the information provided.

Who needs an enrollment application change form?

01
Students: Students who wish to make changes to their enrollment, such as switching programs, adding or dropping courses, or updating personal information, will need an enrollment application change form.
02
Institutions: Educational institutions or organizations use the enrollment application change form to track and process any changes requested by their enrolled students. It helps them maintain accurate records and ensure that students' enrollment details are up to date.
03
Administrators: Academic administrators, such as registrars or student affairs personnel, will need the enrollment application change form to review and process the requested changes. They use the form to update the student's records and make any necessary adjustments to their enrollment status.
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