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Indiana University
Visiting Scholar 
Insurance Plan

Visiting Scholar Custom Enrollment Form
2024-2025 Academic Year

Enter the 2024-2025 visiting scholar enrollment code below. The international office on your campus can give you the enrollment code and permission to access the enrollment form.  

OPT students cannot use this form and must use the OPT Semester or Qualifying Event Enrollment Form 

Asterisk (*) denotes required field

SCHOLAR / STUDENT INFORMATION

 (MM/DD/YYYY)