Interested in our Extras Covers for overseas students?
Fill out the form below with your details and let us know what you’re looking for. Our team will contact you to explain your options and answer any questions.
First name
*
Middle name(s)
Surname
*
Gender
*
-- Select an option --
Male
Female
Date of birth
*
State
*
-- Select an option --
NSW
VIC
ACT
QLD
SA
WA
NT
TAS
Australian contact number
*
E-mail
*
Student visa expiry date
*
What type of cover do you require?
*
-- Select an option --
Single
Couple
Family
Single Parent
I'm not sure
Which Extras services are you interested in being covered for?
*
Major Dental
General Dental
Optical
Physiotherapy
Chiropractic
Osteopathic
Other
Any questions or additional information?
I have read and agree to the
Privacy Policy
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I certify that the information entered in this application for membership is true and correct
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