1. NPAQ has $10,000,000 Public Liability Insurance and Professional Indemnity Insurance cover (PII policy). The Professional Indemnity Insurance policy has full retroactive cover for matters that have occurred in the past but for which a claim notification has not been made.

2. I appoint Nurses' Professional Association of Australia (TPAA) as my agent to act for me with respect to the relevant employee association nominated by me including, if requested and authorised by me, to advise my resignation from any other union of which I may currently be a member.

3. I authorise TPAA to apply on my behalf for membership of the association known as Nurses' Professional Association of Queensland (NPAQ) and agree to abide by its Constitution, by-laws and policies and procedures. I understand my membership application is subject to the terms as set out in this application.

4. I appoint either a nominated representative of the association known as NPAQ, the NPAQ itself, or jointly as above with TPAA, to act as my bargaining agent or representative and authorise them to represent me in any industrial matter or dispute. Such appointment is to apply until withdrawn by me in writing.

5. I confirm that I am joining a member based organisation that provides members' various services on a not-for-profit basis.

6. I declare the details provided in this application are, to the best of my knowledge, true and accurate.