Joining up is easy - just fill in the form!

Before you join HACSU, please read our charter of members’ rights and obligations

Or you join over the phone by ringing HACSUassist on 1300 880 032

Title (required)
 Mr Miss Mrs Ms

First Name (required)

Last Name (required)

Street (required)

Suburb (required)

Postcode (required)

Occupation (required)

Home Email

Work Email

Date of Birth ( dd / mm / yyyy) (required)

Mobile Phone

Telephone Home

Telephone Work

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Employer 1(required)

Work Place 1 (required)

Employer 2

Work Place 2

Employment Status (required)
 Full Time Part time Casual Temporary

What are your hours? (required)
 Under 10 10 - 19 20+

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If you are a Nurse, Health Professional, Ambulance Officer or Personal Carer you must also complete this section
Malpractice, Liability and Legal Benefits Insurance

I, the undersigned, being a financial member of the Health Services Union of Australia hereby give notice that I appoint the said Union as my agent for the purposes of giving and acceptance of notices in respect of Malpractice and Legal Benefits Insurance in accordance with the insurance in accordance with the Insurance Contracts 1984 and its Regulations. I also undertake to report circumstances or claims made against me as soon as possible to the said union.

Name:

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