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Individual Enrolment

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Student Benefits Plan coverage is provided to eligible students automatically, except in certain circumstances where a student’s enrolment status excludes them from automatic inclusion by the institution or due to a previous waiver on file. To enroll in the Student Health and/or Dental plan(s), complete the sections below and submit this form. Upon approval of your request, you will be advised of fees owing , documentation required and payment due date, directly by email. All supporting document(s) and fees must be received by the applicable deadline in order for the enrolment process to be completed.

Please read and agree to the Terms & Conditions prior to submitting your online Enrolment Form.

PLEASE NOTE: ELIGIBLE STUDENTS ARE AUTOMATICALLY CHARGED FOR THE HEALTH AND DENTAL PLAN, PLEASE CHECK YOUR STUDENT FEES BEFORE FILLING THIS FORM OUT.   



Student Information

Gender
Date of Birth
Phone Number
Program Start Date

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