Allied Health Assistants' National Association Ltd

Payment Options

I would like to make a payment of the full Membership Fee.

I would like to make scheduled Monthly Payments of: $9.08 (resident of Australia) / $8.25 (non resident)

I would like to make scheduled Bi-Monthly Payments of: $18.15 (resident of Australia) / $16.50 (non resident)

I would like to make scheduled Quarterly Payments of: $27.23 (resident of Australia) / $24.75 (non resident)

I would like to make scheduled Semi-Annual Payments of: $54.45 (resident of Australia) / $49.50 (non resident)

First Name

Surname

Contact Details

Email Address

Send correspondence to this address

Primary Address

This is your mailing address. Print mail is sent to this address.

Addresses

Home Address
Work Address

Address 1

Suburb / Town

Postcode

State

Country

Address 2

Suburb / Town

Postcode

State

Country

Which Practising Membership class do you believe you're eligible for?

Certified

General

Provisional

Not sure

If you are not found eligible for this membership class, do you agree to be granted the highest practising membership you are eligible for?

Yes

Listing in the Register of AHAs. If yes, please ensure your work suburb and postcode are entered above and enter contact email in the next response.

Yes

Please declare all Suitability Issues here (or N/A for none). Failure to declare all relevant issues may be found to breach the AHANA Code of Conduct.

Gender. NOTE: uses ABS 2021 census gender categories.

Prefer not to say

Male

Female

Non-binary

Most accurate description of your current Allied Health Assistant (AHA) status:

Job title

If working as an AHA, how would you describe your main type of employment as an AHA?

Business owner

Contractor (fee for service)

Employee

Other

Insurance Cover - please note this is subject to spot audit. Please review the Practising Member application instructions and select an option:

I am not practising but will obtain insurance that meets AHANA's minimum requirements within 21 days of commencing practise

I am fully covered by my employer's (or employers') insurance

I have my own insurance which meets AHANA's minimum requirements

I am practising but not currently insured. I agree to obtain insurance that meets AHANA's minimum requirements within 21 days of grant of AHANA practising membership

I am practising and not fully covered by insurance but I do not intend to obtain insurance. NOTE you will be ineligible for membership

Upload details of your AHA employment history, using the template provided in the Application Instructions.

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What is the highest level qualification you have completed?

If you answered "Other" or "International" for your highest qualification, please elaborate.

If you have or are studying an Australian Certificate III or above in Allied Health Assistance, provide the year you finished or will finish.

Please attach certified copies of qualification, academic transcript, statement of attainment and/or record of results (relevant qualifications only).

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In my AHA work, I commonly provide services supporting the following disciplines/fields/roles (select all which apply):

My workplace is best described as:

If your workplace is best defined as "Other", please describe.

Upload evidence of name change, if any supporting documents you provided are for a previous name to the one you are applying under.

Delete

Practising Member Declaration. By submitting this application, I declare (all must be ticked):

That the contents of and attachments provided to this application are accurate and not misleading

That I agree to the terms of the privacy statement provided in the Important Information on the previous page

That I believe my application and the evidence I have provided supports eligibility for AHANA membership

That I will inform AHANA within 14 days if I become aware of an issue affecting my eligibility for membership

That I have declared all membership Suitability Issues

That I understand and agree to comply with AHANA's Insurance Requirements

That I will comply with all AHANA by-laws and other policy requirements

That I agree to comply with the AHANA Code of Conduct

That I (the applicant/organisation) agree to comply with the Continuing Competence Requirements By-law

Payment

Fees Due

Joining Fee:	complete home address to see fee
Membership Fee:	complete home address to see fee

Discount Code

Payment Method

NOTE: A surcharge of 1.864% is added to all Credit Card transactions.

Name on Card

Card Number

CVN Number

Card Expiry

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