Allied Health Assistants' National Association Ltd

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That the contents of and attachments 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 am not practising as an AHA and that if I commence practise will apply for a Practising Membership within 21 days of commencing practise

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Membership Fee:	complete home address to see fee

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

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