Student Medical Insurance Waiver/Enrollment

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Personal Information

First Name: *

Last Name: *

Email Address: *

Insurance Information

Coverage: *

I will be enrolling in one of the student plans

I am currently insured by the carrier and policy listed below

I will be waiving coverage and assume responsibility for all medical expenses

Insurance company name: *

Policy number: *

By entering my initials below, I fully understand that I am legally responsible for any medical expenses incurred during my enrollment at the school and that the school will not be responsible for any medical expenses.

Initials: *

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Jody Gunn
(MDiv Connections)

Jody In the summer of 2006, I made a pact with a high school friend to make our fortieth decade significant. My goal was to complete my Master of Divinity degree before I turned fifty years old. Inside I asked myself and God, "How is this was going to be possible?" Eventually, I was willing to be open to it. My life seemed crazy enough without adding seminary to the mix. I am married to Eric and have two children...