I confirm the information I have provided is true and correct.

I understand that this product only provides cover for individuals when in Australia on particular working visas.

By providing my account details, I agree to the direct debit facility and authorise AIA Health Insurance to debit my nominated account. I understand that AIA Health Insurance will debit my account and that I and AIA Health Insurance will be bound by the terms and conditions set out in the Direct Debit Service Agreement.

I acknowledge and agree to the Fund Rules, Member Guide and Product Fact Sheet that apply to this insurance policy (as updated from time to time).

I agree to AIA Health Insurance collecting, using and disclosing my personal information for the purposes of providing this insurance policy and services in connection with it. I also agree to AIA Health Insurance protecting my personal information in accordance with Australian privacy laws and in the manner described in its Privacy Policy (as updated from time to time).

We confirm the information we have provided is true and correct, and, where relevant, is provided with the consent and authority of the individual(s) to whom it relates. We also confirm any other individuals on this membership have agreed to the below.

We understand that this product only provides cover for individuals when in Australia on particular working visas.

By providing our account details, we agree to the direct debit facility and authorise AIA Health Insurance to debit our nominated account. We understand that AIA Health Insurance will debit our account and that we and AIA Health Insurance will be bound by the terms and conditions set out in the Direct Debit Service Agreement.

We acknowledge and agree to the Fund Rules, Member Guide and Product Fact Sheet that apply to this insurance policy (as updated from time to time).

We agree to AIA Health Insurance collecting, using and disclosing our personal information for the purposes of providing this insurance policy and services in connection with it. We also agree to AIA Health Insurance protecting our personal information in accordance with Australian privacy laws and in the manner described in its Privacy Policy (as updated from time to time).