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Long Term Disability Prevised January 1, 2018, The Enrollment/Change Form is included at the end of this booklet. 377661BSI 14249377661 (12/17)To Become Insured All newly eligible employees are required
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Obtain the enrollmentchange form from the school's administration office.
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Read the instructions on the form carefully.
03
Fill out the personal information section, including your name, address, and contact details.
04
Provide the necessary details regarding the changes you want to make in your enrollment status.
05
Attach any required supporting documents such as proof of address, identification, or letters of recommendation.
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Who needs the enrollmentchange form is?

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The enrollmentchange form is needed by students or individuals who wish to make changes in their enrollment status at a school or educational institution.
02
This could include requesting a change in course schedule, transferring to a different program or school, updating personal information, or withdrawing from a program.
03
It is important to check with the specific school or institution to determine if the enrollmentchange form is necessary for your specific situation.
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The enrollmentchange form is a form used to make changes to an individual's enrollment in a program or system.
Individuals who need to update or modify their enrollment status are required to file the enrollmentchange form.
To fill out the enrollmentchange form, individuals must provide their current enrollment information and indicate the changes they wish to make.
The purpose of the enrollmentchange form is to ensure accurate and up-to-date enrollment information for individuals in a program or system.
The enrollmentchange form usually requires information such as the individual's name, ID number, current enrollment status, and the changes being requested.
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