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Insurance Exemption Form
* Fields are required
First Name
*
Last Name
*
CWID#
*
Date
Address
*
(Not P.O. Box)
City
*
State
*
Zip
*
Email
*
Phone
*
Reason for Insurance Exemption
Graduate assistantship (GA
)
- Please have your department email a confirmation of your full-time graduate assistantship and Human Resource email confirmation of when your GA insurance is effective to John_Jones@tamu-commerce.edu.
Scholarships
- Please provide the ISSO with a copy of your scholarship/financial guarantee. You may email to John_Jones@tamu-commerce.edu, fax to 903-468-3200, or bring by the ISSO in Halladay 104.
Employment based
- You will need to provide a copy of your insurance card AND proof that the coverage meets our minimum requirements listed on the Insurance. Your insurance may provide a letter or email to John_Jones@tamu-commerce.edu confirming the proof of coverage.