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ENROLLMENT FORM Please complete the form, sign, and FAX to 18442373172. For assistance, please call 18444682252 Monday Friday, 8AM to 8PM ET. Gateway to NCAA Services Benefits Verification and Prior
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How to fill out gateway to enrollment form
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Start by providing your personal information such as name, date of birth, and contact information.
02
Fill out the section regarding your current medical coverage, if any.
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Indicate any household members that will be covered under this enrollment.
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Review the form for accuracy and completeness before submitting it.
Who needs gateway to enrollment form?
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Individuals who are seeking to enroll in a specific program or service that requires completion of the gateway to enrollment form.
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