Get Dependent Enrollment Form

Understanding how to complete the Dependent Enrollment Form is essential for ensuring proper insurance coverage for your dependents. This guide will provide step-by-step instructions to help you fill out the form accurately and efficiently.

Follow the steps to successfully complete the form online.

1. Click ‘Get Form’ button to obtain the Dependent Enrollment Form and open it in your preferred editor.
2. Begin by entering your student information. Fill out your last name, first name, middle initial, and the gender selection. Ensure that you also include your CWID and date of birth.
3. Next, provide your mailing address. This should include your house or building number and street name, apartment or PO Box number, city, state, and ZIP code.
4. Identify your insured category by selecting one from the options provided: Domestic Undergraduate, Domestic Graduate, International Undergraduate, or International Graduate.
5. For each dependent you wish to insure, complete the requested details. You will need to enter the name, gender selection, and date of birth for each dependent, including your spouse and children.
6. Review the completed form for accuracy. Make sure all necessary fields are filled out completely and clearly.
7. Once you have finished filling out the form and have confirmed all information is accurate, save your changes. You may then download, print, or share the form as needed.

Start completing your Dependent Enrollment Form online today to ensure your dependents are covered.