Bishop's University > School Fees > Health Insurance Form - etfs

Health Insurance Form - etfs

Application for Health Insurance - etfs

Academic Year 2013-2014 (Sept. 1, 2013 to August 31, 2014)

If you are coming to study at Bishop's and you are bringing your family (spouse, children) with you please contact melanie.roarke@ubishops.ca to find out what we can do for your family in regards to health insurance. Insurance for your family is not mandatory but we do recommend that you look into having coverage of some sort while you are here in Canada.

Rates for 13-14 are not yet confirmed and are subject to change.

Identification

ID #:*

Last Name:*

First Name:*

Date of Birth:*

Gender:*

Country:

Period of Coverage

I am buying health insurance with etfs for the full duration of my stay in 2012-2013:

4 Months $295

8 Months $589

12 Months $884

Method of Payment Accepted

Cash or Interac:	In person at our counter (McGreer Bldg 1st floor)
Cheque:	Make your cheque payable to: Bishop’s University Indicate your ID number on your cheque
BankTransfer:	You must provide a copy of your bank transfer by mail, fax or email to the BUSINESS OFFICE. Beneficiary: Bishop’s University (There is no IBAN number required to do this transaction.)