COA International Studies

Request Letter of COA Insurance Coverage

If you will be studying abroad this year and need a Letter of Insurance Coverage,
please submit this form and a copy will be sent to the following mailing address:

 
     Student Name: 
  Mailing Address: 
             City: 
            State:  Zip Code: 

    Email Address: 
     Phone Number: 

     Time Period*: 

*Period of time you will be abroad.

EXAMPLE: October 1st, 2009 - March 31, 2010

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