Curry College

2014-2015 Policy Year
Student Health Insurance Spring Waiver Form for Non-Traditional Students


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

The deadline to waive the Spring Health Insurance Plan for Non-Traditional Students is March 30, 2015.

Asterisk (*) denotes required field

STUDENT INFORMATION
 
Student ID (@ followed by 8 digits): *
first name: *
last name: *
date of birth: * (MM/DD/YYYY)