I confirm the information I have provided is true and correct.
I understand that this product only provides cover for individuals when in Australia on particular working visas.
By providing my bank account details, I agree to the direct debit facility and authorise Immsure Insurance to debit my nominated bank account. I understand that Immsure Insurance will debit my account, and both I and Immsure Insurance will be bound by the terms and conditions set out in the Direct Debit Service Agreement.
I acknowledge and agree to the Fund Rules, Member Guide, and Product Fact Sheet that apply to this insurance policy (as updated from time to time).
I agree to Immsure Insurance collecting, using, and disclosing my personal information for the purposes of providing this insurance policy and services in connection with it. I also agree to Immsure Insurance protecting my personal information in accordance with Australian privacy laws and as described in its Privacy Policy (as updated from time to time).