Cambridge College
STUDENT HEALTH INSURANCE PLAN

​​Voluntary Enrollment Form 
2021-2022 Academic Year

Students not mandated to enroll in the student health insurance plan can complete this form to enroll. The insurance charge will be added to the tuition statement.

TO CONTINUE THE VOLUNTARY ENROLLMENT PROCESS, PLEASE FILL OUT THE REQUIRED FIELDS BELOW:

Asterisk (*) denotes required field

STUDENT INFORMATION

 (MM/DD/YYYY)