Join OSHC Extras Cover - Enquire Online

First name *

Middle name(s)

Surname *

Gender *

Date of birth *

Home address *

Home address 2

City/Suburb *

State *

Postcode *

Postal address

Same as home address

Postal address

Contact number *

E-mail *

Student visa expiry date *

Product

OSHC Extras

Level of Cover

Single

(If you need cover for a couple or family, please contact us at info@peoplecare.com.au or phone 1300 733 676 so that we can help you choose the best level of cover.)

Product

OSHC Extras

Level of Cover

Single

(If you need cover for a couple or family, please contact us at info@peoplecare.com.au or phone 1300 733 676 so that we can help you choose the best level of cover.)

Claims payments *

Financial institution *

Name of the account holder *

BSB *

Account number *

Previous health fund *

Yes

No

If you have a previous health fund, we will contact you to provide documentation.

Payment frequency *

Bank account direct debit

Financial institution *

Name of the account holder *

BSB *

Account number *

I have read and agree to the Direct Debit Service Agreement *

I have read and agree to the Privacy Policy *

I certify that the information entered in this application for membership is true and correct

Join OSHC Extras

Bank account direct debit

Bank account direct debit

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