BRYANT UNIVERSITY

STUDENT HEALTH INSURANCE PLAN

2018-19 POLICY YEAR

INTERNATIONAL STUDENT
ANNUAL TERM WAIVER FORM

PLEASE NOTE:  THE WAIVER DEADLINE DATE IS NOVEMBER 1, 2018

This form is for returning and new incoming students enrolled in the Fall 2018 semester.


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

first name:
last name:
email address: