| 1a. | First Name: | |
| Last Name: | REQUIRED |
| Middle Name: | |
| 1b. | Sex: | MALE FEMALE |
| 2. | Address: | REQUIRED |
| 3. | Telephone number: | (Work) |
| | (Home) REQUIRED |
| 4. | Fax number: | (Work) |
| | (Home) |
| 5a. | E-mail: | REQUIRED |
| 5b. | Mobile/Cell phone: | |
| 6a. | Age: | |
| 6b. | Date of birth: | |
| 6c. | Countries in which you have lived (and years spent in each country) since birth to 18 years old: |
| | |
| 7. | List all your citizenships/nationalities: |
| | |
| 8. | Do you have a current Australian visa? | Yes / No |
| If 'Yes', What type? | |
| Granted where and when? | |
| Valid until when? | |
| Visa expires when? | |
| Most revent date you entered Australia (as stamped on your passport)? |
| 9. | Languages (spoken and written by you) |
| a) | English language: | You can speak and write in the English language in any situation |
| (select correct answer). | most everyday situations |
| | simple situations |
| | none |
| b) | Name of your Main language: | |
| spoken level: | advanced
/ intermediate
/ basic
|
| written level: | advanced
/ intermediate
/ basic
|
| 10. | Qualifications: TERTIARY OR POST-SECONDARY (IF NOT, THEN SECONDARY) |
| Name of Qualification: | |
| Type of qualification: (select correct answer) |
| | Post-degree Degree
Advanced Diploma
Diploma
Advanced Certificate
Certificate
|
| Full name and address of Institution awarding the qualification: |
| | |
| Private or Government Institution? | |
| Number of years studied full-time: | |
| Commenced studies on (date): | |
| Finished studies on (date): | |
| 11. | Work Experience: | |
|
Describe with important details, your main occupation or work (for instance, if employee
- the 2 most important or highest positions you hold/held including the main duties/responsibilities
for each; if self-employed, the 2 most important or highest positions you hold/held in your business
or businesses including the main duties/responsibilities for each position. |
| a) | Name of position: | |
| Period of employment (mmyy) from to |
| FULLY LIST the details of duties/responsibilities: |
| | |
| b) | Name of position: | |
| Period of employment (mm/yy) from to |
| FULLY LIST the details of duties/responsibilities: |
| | |
| 12. | About Your Relationship With Your Spouse/Partner/Defacto (if applicable) |
| Do you have a spouse/partner/defacto?
Yes
No |
| If 'Yes', then over a period of the last 5 years, for how long were you living together? |
| (If not continuously, please give full details) |
| | |
| 13. | Do you (or your spouse/partner/defacto) have any dependants?
Yes
No |
| If 'yes', provide details as to: age? living with you? to be included in visa application? |
| | |
| 14a. | Do you (or your spouse/partner/defacto) have any relatives who are: |
| Australian citizens/permanent residents?
Yes
No |
| 15. | Any serious health problems with you or your immediate family members?
Yes
No |
| If 'yes', give a brief description. | |
| 16. | Do you or any of your immediate family members have
a serious criminal or adverse immigration record (involving any country)?
Yes
No |
| If 'yes', give a brief description: | |
| 17. | IMPORTANT:What are the main reasons for wanting to visit / reside permanently in Australia? (eg.
to retire; set up businesses/joint ventures; study; go touring; obtain employment; etc) |
| | |
| 18. | ANY OTHER DETAILS about your case which you wish to bring to our attention? |
| | |
| | |
| PART B: DETAILS ABOUT YOUR SPOUSE / DEFACTO / PARTNER (IF APPLICABLE) |
| 19. | Name of spouse/partner/defacto:(First) | |
| (Last) | |
| (Middle) | |
| 20. | Sex: | MALE
FEMALE |
| 21a. | Age: | |
| 21b. | Date of birth: | |
| 22. | List all citizenships/nationalities of your spouse/defacto/partner: |
| | |
| 23. | Does your spouse/defacto/partner have a current Australian visa? Yes
No |
| If 'Yes', What type? | |
| Expires when? | |
| 24. | Languages (spoken and written by your spouse/partner/defacto) |
| English language: | You can speak and write in the English language in any situation |
| (select correct answer). | most everyday situations |
| | simple situations |
| | none |
| 25. | Name of Spouse's Main language: | |
| spoken level: | advanced
/ intermediate
/ basic
|
| written level: | advanced
/ intermediate
/ basic
|
| 26. | Qualifications of spouse/partner/defacto: |
| a. | Name of Qualification on Certificate: | |
| Type of qualification: | Post-degree Degree
Advanced Diploma
Diploma
Advanced Certificate
Certificate
|
| Full name and address of Institution awarding the qualification: |
| | |
| Number of years studied full-time : | |
| Commenced studies on (date): | |
| Finished studies on (date): | |
| 27. | Work Experience of spouse/partner/defacto: |
| Describe with important details, your spouse/partner/defacto's main occupation or work (for instance, if employee
- the 2 most important or highest positions he/she holds/held including the main duties/responsibilities
for each; if self-employed, the 2 most important or highest positions he/she holds/held in his/her
business or businesses including the main duties/responsibilities for each position. |
| a) | Name of position: | |
| Period of employment (mmyy) from to |
| FULLY LIST the details of duties/responsibilities: |
| | |
| b) | Name of position: | |
| Period of employment (mmyy) from to |
| FULLY LIST the details of duties/responsibilities: |
| | |
| | |