OSHC Policy

Policy Summary

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You're applying for the following policy
Provider	Asia Pacific Group Discounted Price in Association with Other Policy Providers
Category	Couple
Policy Duration	08-Apr-2021 - 07-Apr-2023
Cost	AUD $4,361.00

Your Details

Fields marked with '*' are mandatory.

Title*

Given Name*

Given Name:

The name given to you by your family. It is unique to an individual within the family. It should be as mentioned in your passport. For more information or clarity on names, visit this link.

Middle Name

Family Name*

If no Last Name, Use First Name as Last Name

Surname:

The name that your family shares. It should be as mentioned in your passport. For more information or clarity on names, visit this link.

Date of Birth*

Gender*

Male

Female

Other

Home Country*

Home Country:

Fill in the name of the country of your passport.

Passport Number*

Visa Class*

Institute Name*

The institution that you'll be studying at.

Agent

If you are an agent fill your agency name.

Comment

Additional information (if you want to share)

Dependents Details

Title

Name

Surname

DOB

Gender

Relationship

Policy Duration

Policy start*

Start Date:

Policy Start date must be according to the COE start date.
If you are switching from another OSHC provider choose the day after your OSHC expires. In order to keep your visa valid, you must be covered for OSHC continuously.

Policy end*

End Date:

Insurance policy end date must be 2 months after the CoE end date.
Insurance policy end date must be 2.5 months after the CoE end date. If November to December.

Contact Details

Mobile Phone Number*

Email*

Email Confirmation*

We'll be sending your certificate by email, so make sure we've got the right one!

Australian Address Details

Leave these details blank if you don't have an Australian address as of now. Your college address will be considered your address and Membership card will be sent to the same.

Address Line 1

Address Line 2

Postcode

Suburb

State

Terms

Acceptance of Terms

I accept the OSHC Policy Terms and Conditions.

Declaration

I confirm that I will be the primary visa holder and I am eligible to apply for this policy.