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OMB No. 09381378
Expires:7/31/2024INDIVIDUAL ENROLLMENT UNGROUP ELECTION Form can use this form? People with Medicare who want to join a Medicare
Advantage Plan
To join a plan, you must:
Be a United
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01
Obtain necessary enrollment forms from the school or educational institution.
02
Fill out personal information such as name, address, and contact information.
03
Provide any required documentation such as proof of residence or previous educational records.
04
Select desired courses or programs for enrollment.
05
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Who needs melanie wants to enroll?
01
Melanie needs to enroll in a school or educational institution.
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What does Melanie want to enroll in?
Melanie wants to enroll in a specific program or course, although the exact program is not specified.
Who is required to file for Melanie's enrollment?
Typically, the individual enrolling (in this case, Melanie) is required to file for enrollment, possibly along with a guardian if she is a minor.
How to fill out Melanie's enrollment application?
To fill out Melanie's enrollment application, one should gather the required personal information, fill in the specific details of the program, and submit any necessary documentation.
What is the purpose of Melanie's enrollment?
The purpose is likely to gain access to educational opportunities or to fulfill a requirement for a specific course or program.
What information must be reported on Melanie's enrollment?
Information that must be reported typically includes personal details such as name, date of birth, address, contact information, and any prerequisites for the program.
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