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ENROLLMENT FORM In this form, ING Life Insurance and Annuity Company may also be referred to as the Company. Participant Information (please type or print clearly) Employer Name Billing Group Number

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It is typically individuals who wish to enroll in a program, course, or institution who need to fill out an enrollment form. This can include students applying for admission to a school or college, individuals registering for a training program or workshop, or employees enrolling in a benefits program offered by their employer. The specific requirements for needing an enrollment form may vary depending on the organization or institution involved.

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Enrollment form is a document used to register or enroll individuals into a program, course, or organization.

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Individuals who wish to participate or be a member of the program, course, or organization are required to file the enrollment form.

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The purpose of the enrollment form is to gather necessary information about individuals who are interested in joining the program, course, or organization.

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The enrollment form may require information such as personal details, contact information, educational background, and any relevant documentation.

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