Information for Parents  l  Information for Schools

 
 
 
 
 
 





Apply online now
This page is designed for parents and guardians to apply for JUA Student Health Cover, by completing the form below. Your cover will commence upon receipt of payment. Our secure real-time payment system approves transactions in seconds, so your policy can be up and running straight away! We accept Visa, Mastercard and Bankcard.

School Details  
 
  School/College name:  
  Suburb/Town:     Postcode:  
  State:


 
Student details    
  Student's full name:  
  Student's date of birth:


 
Parent or Legal Guardian details  
  Your name:  
  Your address:
 
  Suburb/Town:     Postcode:  
  Your phone number:  
  Your mobile:  
  Your email address:  
  Please confirm that you (parent/legal guardian) are over 18 years of age:
    Yes, I am over 18 years of age

  
  Would you like us to send you an email reminder to reapply next calendar year?
    Yes, please send me an email reminder


  
Acceptance of terms    
  By submitting this form, you aknowledge that you have read and accept the terms defined in the
Product Disclosure Statement & Policy Wording. (PDF 84K)

Tip: To save the PDF, right-click on the link above and select “Save Target As...”
    Yes, I have read and accept these terms


  
  Policy Details    
  Period of Insurance:  Cover commences from 1st January 2009 or the purchase date (where the premium is paid after 1st January 2009) until 31st December 2009

  
  Level of cover: $21.00 AUD per student incl. GST for "Standard Benefits" Cover
$42.00 AUD per student incl. GST for "Double Benefits" Cover

  
   
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    Privacy - Disclaimer

    JUA Student Health Cover
    A product by JUA Underwriting Agency Pty Ltd - ABN: 70 004 566 465 - AFSL: 235411
    Freecall: 180 252 264 - Phone: (03) 9909 7480 - Fax: (03) 9909 7485
    Address: Suite 1610, 530 Little Collins Street, Melbourne, VIC 3000
    Email: reception@studenthealth.com.au