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Click ‘Get Form’ to open the International Student Health Insurance Waiver in the editor.
Begin with Form A: Fill in your Last Name, First Name, and University Student ID#. Indicate your visa type (F-1 or J-1) and student status (Undergraduate or Graduate).
Provide your country of citizenship, birthday, current address, and Hawaii address. If you haven't determined your Hawaii address yet, simply write 'TBD'.
Complete the estimated dates of arrival and departure in Hawaii. Ensure all information is accurate before proceeding.
In the waiver qualification section, select the appropriate category that applies to you and attach any required documents.
Initial each statement acknowledging your understanding of health insurance responsibilities. This confirms you are waiving out of HPU’s student health insurance plan.
Move on to Form B: Use this worksheet to compare your health insurance plan against HPU's minimum requirements. Fill in all necessary details accurately.
Once both forms are completed, submit them to the Dean of Students Office by the specified deadline for clearance.
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Sheet1
900 FORT STREET MALL STE 1850, HONOLULU, HI, 96813, 900 FORT STREET MALL STE 1188 BISHOP ST SUITE 2606, HONOLULU, HI, 96813, 1188 BISHOP ST SUITE 2606
2013 Codebook Report Land-Line and Cell-Phone data
Aug 15, 2014 Page 105. BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM. CODEBOOK REPORT, 2013. Land-Line and Cell-Phone data - version 1. 105 of 133. August 15
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