Niagara College Student Administrative Council Inc.
Individual Student Opt IN Form 2020-2021
This form is to be used ONLY when a student does not normally qualify for benefits.
NOT AVAILABLE FOR SPRING/SUMMER TERM!
STUDENT INFORMATION *mandatory
After reviewing the flex plan options found on , please indicate below which Flex Plan Option you would like to enroll in.
Please indicate one of the following options:
Balanced, Enhanced Drug/Vision, Enhanced Dental/ Vision, Enhanced EHC/Vision.
This form is to be used ONLY when a student does not normally qualify for benefits. If you are a full-time fee paying student, you do NOT complete this form. By clicking 'Proceed to Checkout' you are agreeing that the above information is accurate, and true.