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  • Enrollment / Change Forms - Moravian College

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OF BIRTH CITY SOCIAL SECURITY NUMBER GENDER Male Female EFFECTIVE DATE OF COVERAGE OR CHANGE STATE ZIP CONTRACT TYPE REQUESTED Single (S) Employee + 1 (L) Family Employee + 2 or more (F) DATE OF HIRE COMPLETE THE FOLLOWING FOR ALL FAMILY MEMBERS FOR WHOM YOU ARE REQUESTING COVERAGE PLEASE CHECK THE APPROPRIATE ACTION CODES FOR CHANGES THIS CHANGE IS FOR: TYPE OF CHANGE: EMPLOYEE NEW ENROLLMENT ISSUE CARD LAST NAME SPOUSE DEPENDENT(S) CHANGE OF ADDRESS CANCEL COVERAGE NAME CHAN.

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How to fill out the Enrollment / Change Forms - Moravian College online

Completing the Enrollment / Change Forms for vision coverage at Moravian College is a straightforward process. This guide provides step-by-step instructions to help you accurately fill out the required information online.

Follow the steps to successfully complete the form.

  1. Press the ‘Get Form’ button to access the Enrollment / Change Forms and open it in your preferred editor.
  2. Begin filling out the form by entering the employer (group) name, which should be Moravian College, alongside the group number (51093 0000 01).
  3. Input your personal details, starting with your last name, first name, and middle initial. Then provide your street address, date of birth, city, and state.
  4. Enter your social security number and gender by checking the appropriate option (Male/Female).
  5. Indicate the effective date of coverage or any changes you’re requesting. This is important for determining when your coverage begins.
  6. Select the contract type you are requesting, choosing from 'Single (S)', 'Employee + 1 (L)', or 'Family (F)'.
  7. Provide your date of hire, which is necessary for processing enrollment requests.
  8. Complete the section for family members if you are requesting coverage for them. List their last names, first names, initials, genders, dates of birth, and indicate if they are students (Y/N).
  9. Check the appropriate action codes for changes you wish to make to your coverage. This can include new enrollment, change of address, cancel coverage, or reinstatement.
  10. Review the section indicating the type of change you are submitting. This could include 'New Enrollment', 'Change of Address', 'Cancel Coverage', etc.
  11. Ensure that you complete the signature fields at the end of the form. You need to provide your signature along with the date, followed by your employer's signature and date.
  12. Finally, save your changes, and you may choose to download, print, or share the completed Enrollment / Change Form as needed.

Start your process today and complete the Enrollment / Change Forms online!

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An enrollment change form allows students to officially request alterations to their enrollment status at Moravian College. Whether you need to change your course load, drop a class, or transition between full-time and part-time status, this form facilitates those adjustments smoothly. It ensures that the college keeps accurate records and helps you manage your academic journey effectively. Using the Enrollment / Change Forms - Moravian College is a straightforward way to navigate these changes.

The enrollment form is vital for prospective students seeking admission to Moravian College. It collects essential information, like academic history and personal details, necessary for the admissions team to evaluate your application. Completing this form initiates your journey toward acceptance and provides access to academic resources. The enrollment form is your first step in becoming part of our vibrant community.

Change in enrollment refers to any modifications in a student's academic status at Moravian College. This could include switching majors, dropping or adding courses, or updating your enrollment status from full-time to part-time. These updates are crucial for maintaining accurate records and ensuring that your educational path aligns with your goals. If you need assistance with this process, Enrollment / Change Forms - Moravian College can provide the necessary support.

An enrollment deposit form serves as a commitment to Moravian College, signaling your intention to join the academic community. This form typically requires a monetary deposit, which secures your place in the program of your choice. It plays a pivotal role in the enrollment process, helping the college to arrange necessary resources for incoming students. With the enrollment deposit form, you take a significant step toward starting your educational journey.

The health enrollment form is essential for students at Moravian College to secure their healthcare coverage. By completing this form, you ensure that you are enrolled in the appropriate health insurance plan offered by the college. This helps you avoid any gaps in coverage and access necessary medical services promptly. Ultimately, a well-filled health enrollment form contributes to your overall well-being during your studies.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232