MNSure Enrollment Event Registration

Name*

First Last

Phone*

Email*

Enrollment Event Date*

Please select the event date you wish to attend

Preferred Time*

Please select a preferred time to meet with an assistor at this event. We will contact you with you time slot shortly.

Preferred Time*

Please select a preferred time to meet with an assistor at this event. We will contact you with you time slot shortly.

Preferred Time*

Please select a preferred time to meet with an assistor at this event. We will contact you with you time slot shortly.

Preferred Time*

Please select a preferred time to meet with an assistor at this event. We will contact you with you time slot shortly.

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