International Student Health Insurance

International Student Health Insurance

Early Enrolment Request Form
If you arrive in Canada before your program start date, you can purchase early arrival coverage:
- Go to GuardMe Early Arrivals
- Ensure you have your MITT policy number and start date ready when requesting coverage.
SECTION A: Student Information
Legal Name:*

First/Given NameMiddle NameLast/Family Name
Student Number*
Program Information

Program NameIntake
Date of Birth*

MonthDayYear
Date
Email*
example@example.com
Mailing Address*

Street Address

Street Address Line 2

CityProvince

Postal Code
SECTION B: Early Enrolment Request
Health insurance is mandatory for international students studying in Canada. Students may request early enrolment into the health insurance plan offered by MITT.
Read and confirm the following:*

I request early enrolment into the health insurance planI understand I cannot opt out of the health insurance planI confirm I do not have coverage from Manitoba Health
I have read and understand the information on this form. *

Clear
Should be Empty:

SECTION A: Student Information