Geoffrey Fox

1657 Bellemeade Drive
Bloomington
IN 47401-8671

Phone 3152546387 Cell

My daughter Pamela Fox will join USC Fall 2002
Her SSN is 559-83-7456

I enclose documentation that she is covered by Anthem Blue Cross
Blue Shield Health Insurance obtained through Indiana University
We have PPO Plus coverage -- summary enclosed

Subscriber Name is Geoffrey C. fox
ID No is YRP215529736
Group No 00010190
Plan No. 332

I hereby request waiver of Student Health Fee

Yours Sincerely


Geoffrey C Fox

June 8 2002