Students

Online Membership

To apply for FREE Student Membership simply complete the form below and click the submit button.

Important note: Becoming a FREE Student Member does not provide you with medical indemnity cover. In order to secure medical indemnity cover you will need to apply for a Student Indemnity Policy.

If you would like more information about FREE Student Membership, please contact Member Services on FREECALL 1800 011 255.

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Title:*  
Surname:*  
Given Name:*  
Middle Name:
M/F:*
Address 1:*  
Address 2:
Address 3:
City:*  
State:*  
Postcode:*    
Telephone:*  
Mobile:
E-Mail:*   
Please inform us of any change to the above information
Date of birth:*
(DD-MM-YYYY)    
Name of Medical School:*  
Expected Year of Final Exams(YYYY):*