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VEI 2018 EMPLOYEE ELECTION SHORT FORM District Name: Maple Run Unified School DistrictPlan Selection: Platinum Gold CDP Silver CDP Not electing coverage for 1/1/18 Social Security number (SSN):Group/Account
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Any employee eligible to vote in the vehi 2018 employee election needs to fill out the form. This includes all employees who are registered voters and are authorized to participate in the election process.

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