Roger Williams University
STUDENT HEALTH INSURANCE PLAN

Spring Enrollment Form for Undergraduate, Master in Architecture and School of Law Students

2018-2019 Academic Year

I want to purchase the Roger Williams University Student Health Insurance Plan. I understand that my student account will be billed the proper amount based on the coverage I elect.

Please enter your 7-digit RWU Student ID and date of birth below. New students enrolling at RWU for the 2018-19 academic year will be able to access the form once you receive your RWU student ID number, which will be included in a separate mailing once RWU receives your deposit.

date of birth: (MM/DD/YYYY)
student ID: