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Indiana University
Graduate Fellows, Student Academic Appointees & Appointed Post-Doctoral Fellows

Dependent Enrollment Form
2024-2025 Academic Year

Eligible Graduate Fellows, Student Academic Appointees, and appointed Post-Doctoral Fellows may insure their dependents, including their spouse and children. 

TO CONTINUE THE ENROLLMENT PROCESS, PLEASE FILL OUT THE REQUIRED FIELDS BELOW:

Asterisk (*) denotes required field

 (MM/DD/YYYY)