SoCAA Application Form

  1. Please submit your application to join Students of CAA (SoCAA) using the form below.

    Membership of SoCAA and CAA Interest Groups are free for students.

  2. First Name*
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  3. Last Name*
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  4. Email*
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  5. Address*
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  6. Suburb*
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  7. State*
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  8. Post Code*
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  9. Country*
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  10. Date of birth*
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    dd.mm.yyyy
  11. Gender*

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  12. Phone (home)
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  13. Mobile*
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  14. Would you like to also join any of CAA interest groups
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  15. Can we keep you updated with important news on your mobile?
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    In ticking this box, you are agreeing that CAA can send you SMS updates, which you can unsubscribe from at any time.
  16. Which University are you enrolled at?*






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  17. Other
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  18. Can we check your enrolment status with your University?
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    In ticking this box, you are agreeing that CAA can contact your University to check you are a current student, which you can unsubscribe from at any time.
  19. Year studies commenced?
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    eg. 2011
  20. Anticipated year of Graduation
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    Anticipated year of Graduation :: the year your studies will end (not necessarily the year you attend a graduation ceremony)
  21. Current year of study





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    Current year of study :: full time equivalent
  22. Are you transferring from another CAA branch?

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  23. Please specify which CAA branch you are transferring from?
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  24. What prompted you to become a member?






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  25. Which are the KEY services/benefits you are planning to use?






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  26. Do you want to participate in the FREE CAA Student Master Policy from Guild for Liability Insurance?*

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  27. To Your knowledge, has there been or is there now pending any Claim, action, complaint, inquiry, disciplinary proceedings or other litigation against You?

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  28. After inquiry, are You aware of any fact, situation or circumstance that may give rise to a claim, inquiry, disciplinary proceedings or other litigation against You?

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  29. If You have answered 'Yes' to any of the above questions, please provide further information below as your application will be referred to Guild Insurance Limited for an individual review. You may be contacted for additional information. Please note that your membership information will be provided to the insurer.
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  30. Duty of Disclosure
    Before you become insured under the CAA Student master Policy, the CAA has a duty of disclosure under the Insurance Contracts Act 1984. In order for the CAA to comply with this duty, you must disclose to the insurer every matter that you know, or could reasonably be expected to know, is relevant to the insurer's decision whether to accept the risk of insurance and, if so, on what terms.

    The duty of disclosure also applies before cover is renewed, varied or reinstated. The duty does not, however, require disclosure of a matter:

    • that diminishes the risk to be undertaken by the insurer
    • as to which the duty of disclosure is waived by the insurer
    • that the insurer knows, or in the ordinary course of its business, ought to know
    • that is common knowledge.

    Non-disclosure
    If the duty of disclosure is not complied with, the insurer may be entitled to reduce its liability under the contract in respect of a claim or may cancel the contract. If the non-disclosure is fraudulent, the insurer may also have the option of avoiding the contract from its beginning.

  31. Declaration
    I declare the answers and information given in this declaration are true and correct and I have not withheld any information likely to affect the terms and conditions of the insurance provided under the CAA Student Master Policy. *
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  32. I agree that upon acceptance of this declaration the insurance will be subject to the terms, conditions, exclusions and provisions of the CAA Student master Policy underwritten by Guild Insurance Limited (GIL) *
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  33. I authorise GIL to make any necessary checks of other insurers to confirm the information I have supplied in this Declaration.*
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  34. Privacy
    I consent to the collection, use and disclosure of your personal information to evaluate, effect, manage and administer your insurance cover provided to you by GIL under the CAA Student master Policy. This applies to personal information provided previously, currently and in the future.*
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  36. In submitting this SoCAA application form, I hereby certify that all the statements in this application for membership are complete and true.
    Please note: Resignations from the Chiropractors' Association of Australia must be in writing giving one calendar month's notice; you are liable for all membership fees up till the expiration of that resignation notice.
    Upon submission, your application will be supplied to your relevant CAA State branch for processing.