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Student Application Form

Osteopathy Australia Student Membership 2017-18

* = mandatory field

Personal Details

University

Please Note:

A 5th Year student is required to join Osteopathy Australia as a student member by 30 June in their final year, to be eligible to apply for Graduate membership after graduation.

Student Membership Period

For 2017/18 cycle

1st Year: 1 Feb 2017 - 30 Jun 2018 (up to 17 months membership) 2nd Year: 1 Jul 2017 - 30 Jun 2018 3rd Year: 1 Jul 2017 - 30 Jun 2018 4th/5th Year: 1 Jul 2017 - 31 Dec 2018 (18 months membership)

Declaration

By completing and submitting this form, I declare all the information above to be true and correct. I give permission for the information contained on this membership form to be held by Osteopathy Australia. I give permission and understand my personal details will be confirmed with SOMA or a university representative.

Accept*