Avant and Interplast

Student Placement Program

2014 Application Form

mutual group

Win a once in a lifetime learning

opportunity with an Asia-Pacific
field trip from Avant and Interplast^
Open to all Avant medical student members, this is an exclusive
opportunity to gain invaluable experience and also gain insights
into a surgical specialty.

This is an invaluable
experience for a medical
student, incomparable to what
we do in any metropolitan
Australian hospital.
Dinuksha De Silva
2013 competition winner, Avant member

Scan the QR code to see more

about Dinukshas story

All Avant student members receive free premium travel insurance*.

About Interplast
Interplast is a not-for-profit organisation working to improve the quality of life for people with disability
who are disabled as a result of congenital or acquired medical conditions such as cleft lip and palate
or burn scar contractures.
For 30 years Interplast have been sending volunteer teams of fully qualified plastic and reconstructive
surgeons, anaesthetists, nurses and allied health professionals to the Asia Pacific region to provide free
surgical treatment for patients who would otherwise not be able to afford access to such services.

About the trip

There is one prize to be awarded, consisting of one return flight for a student to participate as an
observer of the Interplast field trip to an Asia Pacific destination (as confirmed by Interplast), to be held
in 2015. Flights, accommodation and meals are paid for by Avant.
The Interplast field trip will be on dates to be determined, and for a period of 3-4 days. The date/s and
location of the field trip are subject to change.

How to Enter
Complete the form on the back page OR
Visit avant.org.au/interplast and complete the online application
Entries close 30 November 2014

Dont miss out on this once in a lifetime opportunity

apply for the Avant and Interplast Student Placement
Program today.
avant.org.au/interplast

1800 128 268

Not an Avant Student Member? Join Avant for free today at avant.org.au/student#

*Travel insurance is available under a Group Policy between Accident & Health International Underwriting Pty Limited ABN 26 053 335 952 and Avant Mutual
Group Limited ABN 58 123 154 898. The issuers are CGU Insurance Limited ABN 27 004 478 371 and AIA Australia Limited ABN 79 004 837 861. Travel insurance is
subject to registration with Avant prior to each trip. For full details including the restrictions, terms, conditions and exclusions that apply, please read and consider
the PDS, available at avant.org.au or by contacting us on 1800 128 268. ^Location may change at Interplasts discretion. Exact dates to be confirmed and may be
subject to change. See terms and conditions at avant.org.au #IMPORTANT: Professional indemnity insurance products available from Avant Mutual Group Limited
ABN 58 123 154 898 are issued by Avant Insurance Limited, ABN 82 003 707 471, AFSL 238 765. The information provided here is general advice only. You should
consider the appropriateness of the advice having regard to your own objectives, financial situation and needs before deciding to purchase or continuing to hold a
policy with us. For full details including the terms, conditions, and exclusions that apply, please read and consider the policy wording and PDS, which is available at
www.avant.org. au or by contacting us on 1800 128 268. Applications are subject to approval.

Avant and Interplast Student Placement Program 2014 Application Form

First Name:
Last Name:
Contact Number:
Email Address:
University:
Year of Study:

Date of birth:

Avant Membership No.: #

1. Why do you want to be a part of the Avant and Interplast Student Placement Program?

2. Why do you think you are a suitable candidate to accompany the Interplast team
(e.g. your skills, training and experience that you believe will be an advantage)?

3. What will you do to promote Interplast upon your return?

Please return to marketing@avant.org.au

2700 C/04-14

mutual group