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Signature of Student Required Date Any fraudulent or misrepresented information will result in an o cial student misconduct report to the UNO Student Accountability and Advocacy O ce. Please see Instructions at http //oiss. uno. edu/UNOinsurancereq2. cfm before completing the form UNIVERSITY OF NEW ORLEANS F-1 INSURANCE COVERAGE EVALUATION FORM SUMMER 2015 This form must be submitted to the O ce of International Students and Scholars may be faxed to 504-280-7317 or e-mailed to oiss uno. Edu...

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