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Waiver Request CompletePrivacy Policy Help <br />Complete Please print this page for your records then click the Logout button below. Transaction Number  388227Completion Date  7/13/2010 5:07:06 PM Enrollee Information First NameMILast NameLor VueBirth DateGender1/20/1990MaleAddress While Attending SchoolAddress1Address2CityStateZip1347 Ames AveSt. PaulMN55106Email AddressPhone NumberClass Yearvuel@carleton.edu651-500-54082012Other Insurance Information Group NameGroup NumberUcare00050079700Name of Insurance CompanyPolicy NumberUcare01080081Address1Address2CityStateZip500 Stinson Boulevard N.E.MinneapolisMN55413Maintain InsuranceStudy ProgramYesNo    <br />

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  • 1. Waiver Request CompletePrivacy Policy Help <br />Complete Please print this page for your records then click the Logout button below. Transaction Number  388227Completion Date  7/13/2010 5:07:06 PM Enrollee Information First NameMILast NameLor VueBirth DateGender1/20/1990MaleAddress While Attending SchoolAddress1Address2CityStateZip1347 Ames AveSt. PaulMN55106Email AddressPhone NumberClass Yearvuel@carleton.edu651-500-54082012Other Insurance Information Group NameGroup NumberUcare00050079700Name of Insurance CompanyPolicy NumberUcare01080081Address1Address2CityStateZip500 Stinson Boulevard N.E.MinneapolisMN55413Maintain InsuranceStudy ProgramYesNo    <br />