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UnitedHealthcare INSURANCE COMPANY CONTINUATION ENROLLMENT FORM FOR GRADUATE STUDENTS AND THEIR DEPENDENTS WASHINGTON AND LEE UNIVERSITY2017145167PRIMARY INSURED COMPLETE INFORMATION BELOW FOR STUDENT. SOCIAL

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How to fill out continuation enrollment form for

01

Step 1: Start by obtaining the continuation enrollment form from the relevant institution or organization.

02

Step 2: Read through the form carefully and make sure you understand all the instructions and requirements.

03

Step 3: Provide your personal information accurately and legibly, including your name, address, contact details, and any other required details.

04

Step 4: Fill in the enrollment details, such as the program or course name, start and end dates, and any specific instructions related to the continuation of your enrollment.

05

Step 5: If there are any fees or payments associated with the continuation enrollment, make sure to include them in the designated sections of the form.

06

Step 6: Review the completed form to ensure all the information is accurate and complete.

07

Step 7: Sign and date the form in the designated section to confirm your consent and agreement with the provided information.

08

Step 8: Submit the filled-out continuation enrollment form to the appropriate institution or organization as per their instructions, either in person, by mail, or through their online portal.

Who needs continuation enrollment form for?

01

The continuation enrollment form is needed by individuals who wish to continue their enrollment in a program or course at a specific institution or organization. It is typically required for students who have completed a previous term or semester and intend to continue their studies in the following term or semester.

02

Other individuals who may need the continuation enrollment form include professionals seeking to maintain their certification or membership in a professional organization by completing ongoing education requirements.

03

Additionally, individuals who had taken a break in their enrollment and now wish to resume their studies may also be required to fill out a continuation enrollment form.

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What is continuation enrollment form for?

Continuation enrollment form is used to maintain enrollment in a program or plan without interruption.

Who is required to file continuation enrollment form for?

Individuals who wish to continue their enrollment in a program or plan are required to file continuation enrollment form.

How to fill out continuation enrollment form for?

To fill out continuation enrollment form, individuals must provide updated information and follow the instructions provided by the program or plan administrator.

What is the purpose of continuation enrollment form for?

The purpose of continuation enrollment form is to ensure that individuals can maintain their enrollment without any gaps or disruptions.

What information must be reported on continuation enrollment form for?

The information that must be reported on continuation enrollment form includes personal details, updated contact information, and any changes in circumstances that may affect enrollment.

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