1208 - Application for a Work and Holiday visa - Travisa

Application for a Work and Holiday visaForm1208Life in Australia – Australian valuesThe Australian Government encourages people to gain anunderstanding of Australia, its people and their way of life,before applying for a visa to live in Australia. As part of thisapplication every person aged 18 years or over must declarethat they will respect Australian values, as outlined below andobey the laws of Australia.Australian values include respect for the freedom anddignity of the individual, freedom of religion,commitment to the rule of law, Parliamentarydemocracy, equality of men and women and a spirit ofegalitarianism that embraces mutual respect, tolerance,fair play and compassion for those in need and pursuitof the public good.Australian society also values equality of opportunityfor individuals, regardless of their race, religion orethnic background.It is also important to understand that English is the nationallanguage.Further information is contained in the Life in Australiabooklet, however, you are not required to read the booklet.The booklet is available in a wide range of languages. If youwould like a copy of the booklet it can be obtained fromwww.immi.gov.auAbout this formImportant – Please read this information carefully before youcomplete your application. Once you have completed yourapplication we strongly advise that you keep a copy for yourrecords.Note: Any reference in this form to ‘country’ refers to ‘foreigncountry’ which is defined in paragraph 22(1)(f) of the ActsInterpretation Act 1901 as any country (whether or not anindependent sovereign state) outside Australia and the externalterritories.Who should use this application?Applicants applying for a Work and Holiday (subclass 462) visa.Each applicant must apply individually and cannot include familymembers in their application.Online applicationsApplicants from the United States of America (USA) may applyon the Department of Immigration and Citizenship (thedepartment) website. Payment must be made by credit card foronline applications. Further information is available from thedepartment’s website www.immi.gov.au/visitors/If you wish to apply online do not use this application.Visa overviewThe Work and Holiday visa program encourages culturalexchange and closer ties between arrangement countries byallowing young people to have an extended holidaysupplemented by short-term employment.A Work and Holiday visa allows the visa holder to:• enter Australia within 12 months of the date of visa grant;• stay in Australia for up to 12 months;• leave and re-enter Australia any number of times while thevisa is valid;• work in Australia for up to 6 months with each employer;and• study for up to 4 months.Arrangement countriesAustralia currently has reciprocal Work and Holidayarrangements with:• Argentina;• Bangladesh;• Chile;• Indonesia;• Malaysia;• Thailand;• Turkey;• the USA; and• Uruguay.Note: There is an annual limit to the number of visas that maybe issued to applicants from:• Argentina;• Bangladesh;• Chile;• Indonesia;• Malaysia;• Thailand;• Turkey; and• Uruguay.If the limit has been reached, applicants will be notified and theprocessing of their application may be delayed.Australia continues to negotiate Work and Holiday arrangementswith additional countries. To see whether any arrangementshave been established with additional countries, check thedepartment’s website www.immi.gov.au/visitors/Integrity of applicationThe department is committed to maintaining the integrity ofthe visa and citizenship programs. Please be aware that if youprovide us with fraudulent documents or claims, this may resultin processing delays and possibly your application being refused.© COMMONWEALTH OF AUSTRALIA, 20131208 (Design date 03/13) - Page 1

Eligibility requirementsTo be granted a visa, there are a number of eligibilityrequirements that applicants must meet.All applicants must:• be aged between 18 years and 30 years inclusive (at the timeyou apply);• hold a passport from an eligible country, preferably valid forat least 6 months;• have functional English;• meet education requirements (see tables on pages 2 and 3);• not be accompanied by dependent children;• be outside Australia when you apply and when the visa isgranted;• not have entered Australia on a Work and Holiday(subclass 462) or Working Holiday (subclass 417) visa;• have sufficient funds (generally AUD5,000);• have funds for a return or onward ticket to depart Australia(or an actual ticket);• have health insurance (recommended) covering your stay inAustralia. This can be obtained in your home country or inAustralia. More information is available fromwww.immi.gov.au/visitors;• meet Australia’s health requirement – depending on thecountry you are from and your intentions in Australia (suchas entering a hospital, health care area, childcare centre orclassroom), you may need to undertake a medicalexamination. More information is available fromwww.immi.gov.au/allforms/health; and• meet Australia’s character requirement. More information isavailable from www.immi.gov.au/allforms/characterApplicants from Argentina, Bangladesh, Chile, Indonesia,Malaysia, Thailand, Turkey and Uruguay must also:• provide a letter of approval from your government agreeingto your stay in Australia under the Work and Holiday visaarrangement (the letter of support does not guarantee aplace in the Work and Holiday program); and• provide proof of English proficiency.BangladeshChileHold tertiary qualifications, or havesuccessfully completed at least 2 years ofundergraduate university study.Tertiary qualifications include a:• Doctoral degree;• Masters degree;• Graduate diploma;• Graduate certificate;• Bachelor degree;• Associate degree;• Advanced diploma;• Diploma level qualifications.Note: Tertiary qualifications do not include:• Certificate IV;• Certificate III;• Certificate II;• Certificate I;• Senior Secondary Certificate of Education.Hold tertiary qualifications or havesatisfactorily completed or have beenapproved to undertake a third year ofundergraduate university study.Tertiary qualifications include a:• Doctoral degree;• Masters degree;• Graduate diploma;• Graduate certificate;• Bachelor degree;• Associate degree;• Advanced diploma;• Diploma;• Certificate IV;• Certificate III level qualifications.Note: Tertiary qualifications do not include:• Certificate II;• Certificate I;• Senior Secondary Certificate of Education.ArgentinaHold tertiary qualifications, or havesuccessfully completed at least 2 years ofundergraduate university study.Tertiary qualifications include a:• Doctoral degree;• Masters degree;• Graduate diploma;• Graduate certificate;• Bachelor degree;• Associate degree;• Advanced diploma;• Diploma level qualifications.Note: Tertiary qualifications do not include:• Certificate IV;• Certificate III;• Certificate II;• Certificate I;• Senior Secondary Certificate of Education.IndonesiaHold tertiary qualifications, or havesuccessfully completed at least 2 years ofundergraduate university study.Tertiary qualifications include a:• Doctoral degree;• Masters degree;• Graduate diploma;• Graduate certificate;• Bachelor degree;• Associate degree;• Advanced diploma;• Diploma level qualifications.Note: Tertiary qualifications do not include:• Certificate IV;• Certificate III;• Certificate II;• Certificate I;• Senior Secondary Certificate of Education.1208 (Design date 03/13) - Page 2 © COMMONWEALTH OF AUSTRALIA, 2013

MalaysiaHold tertiary qualifications, or havesuccessfully completed at least 2 years ofundergraduate university study.Tertiary qualifications include a:• Doctoral degree;• Masters degree;• Graduate diploma;• Graduate certificate;• Bachelor degree;• Associate degree.Note: Tertiary qualifications do not include:• Advanced diploma;• Diploma level qualifications;• Certificate IV;• Certificate III;• Certificate II;• Certificate I;• Senior Secondary Certificate of Education.UruguayHold tertiary qualifications, or havesuccessfully completed at least 2 years ofundergraduate university study.Tertiary qualifications include a:• Doctoral degree;• Masters degree;• Graduate diploma;• Graduate certificate;• Bachelor degree;• Associate degree;• Advanced diploma;• Diploma level qualifications.Note: Tertiary qualifications do not include:• Certificate IV;• Certificate III;• Certificate II;• Certificate I;• Senior Secondary Certificate of Education.ThailandTurkeyUnitedStates ofAmericaHold tertiary qualifications.Tertiary qualifications include a:• Doctoral degree;• Masters degree;• Graduate diploma;• Graduate certificate;• Bachelor degree;• Associate degree;• Advanced diploma;• Diploma level qualifications.Note: Tertiary qualifications do not include:• Certificate IV;• Certificate III;• Certificate II;• Certificate I;• Senior Secondary Certificate of Education.Hold tertiary qualifications, or havesuccessfully completed at least 2 years ofundergraduate university study.Tertiary qualifications include a:• Doctoral degree;• Masters degree;• Graduate diploma;• Graduate certificate;• Bachelor degree;• Associate degree;• Advanced diploma;• Diploma level qualifications.Note: Tertiary qualifications do not include:• Certificate IV;• Certificate III;• Certificate II;• Certificate I;• Senior Secondary Certificate of Education.Hold a Senior Secondary Certificate ofEducation or equivalent.How much does the visa cost?Payment must accompany your application and is generally notrefunded if the application is unsuccessful. To check the VisaApplication Charge, see form 990i Charges available from thedepartment’s website www.immi.gov.au/allforms/990i.htmor check with the nearest office of the department.Fees may be subject to adjustment at any time. Visa ApplicationCharges may be subject to adjustment on 1 July each year. Thismay increase the cost of a visa.Method of paymentOutside AustraliaBefore making a payment outside Australia, please check withthe Australian Government office or Visa Application Centrewhere you intend to lodge your application as to what methodsof payment and currencies they can accept and to whom thepayment should be made payable.How to applyStep 1Complete this application.Please use a pen, and write neatly in English using BLOCKLETTERS.You must provide the address where you intend to live whileyour application is being processed. Failure to give a residentialaddress in your application will result in your application beinginvalid. A post office box address will not be accepted as yourresidential address.Step 2Contact the Australian Government office or Visa ApplicationCentre in the country which issued your passport to confirmapplication arrangements (eg. whether there are any additionallocal requirements). More information is available fromwww.immi.gov.au/contacts/overseas/© COMMONWEALTH OF AUSTRALIA, 20131208 (Design date 03/13) - Page 3

Step 3Lodge your completed application and required attachments(see Application checklist on page 6 of this application) asoutlined below.Applicants from the USA can lodge their application by post,fax or hand delivering this application to any AustralianImmigration office overseas. Applicants from Argentina, Chile,Indonesia, Thailand and Turkey can lodge their application bypost, fax or hand delivering this application to the AustralianImmigration office in their country of passport. Applicants fromUruguay can lodge their application by post, fax or handdelivering this application to the Australian Immigration officein Argentina.Do not send cash or your passport with your application.Applicants from Bangladesh or Malaysia need to provide theirbiometrics (fingerprints scan and facial photograph) at a VisaApplication Centre when lodging an application.More information is available fromwww.immi.gov.au/contacts/overseas/If you lodge your application with the Australian ImmigrationOffice in Dkaha, Bangladesh or Kuala Lumpur, Malaysia you willbe required to attend a Visa Application Centre in person toprovide your biometrics.What happens next?Your application will be assessed. You may be asked to provideadditional information to enable a decision to be made. You willbe advised in writing whether your application has beenapproved. If your application is refused, you will be givenreasons for the decision.You should not make any irreversible travelarrangements until you receive written advice of thedepartment’s decision on your application.Note: If you are granted an Electronic Travel Authority (ETA) orMaritime Crew visa (MCV) as well as a Work and Holiday visa,you will activate the Work and Holiday visa on arrival in Australia,rather than the ETA or MCV. This will activate the 12 month stayperiod of the Work and Holiday visa, which will not be able tobe postponed or deferred. If you want to travel on the ETA orMCV, you must have your Work and Holiday visa cancelledbefore travelling to Australia. You will be able to apply for aWork and Holiday visa in the future, provided you meet theeligibility requirements.Important – change of personal/passport detailsIf you wish to change any details after you lodge yourapplication, including your passport details, or if you wish towithdraw the application, please contact the department:• Applicants from Argentina, Bangladesh, Chile,Indonesia, Malaysia, Thailand, Turkey and Uruguay –contact the Australian Immigration office overseas or VisaApplication Centre where you lodged your application. Moreinformation is available fromwww.immi.gov.au/contacts/overseas/• Applicants from the USA – E-maileVisa.WANDH.Helpdesk@immi.gov.auYour Work and Holiday visa application is linked to the passportnumber provided in your application. If you are granted avisa, but do not provide the department with the detailsof any new passport you use to travel to Australia, youwill experience significant delays at the airport andcould be denied permission to board your plane.Immigration assistanceA person gives immigration assistance to you if he or she uses,or claims to use, his or her knowledge or experience inmigration procedure to assist you with your visa application,request for ministerial intervention, cancellation reviewapplication, sponsorship or nomination.In Australia a person may only lawfully give immigrationassistance if he or she is a registered migration agent or isexempt from being registered. Only registered migration agentsmay receive a fee or reward for providing immigrationassistance.If an unregistered person in Australia, who is not exempt fromregistration, gives you immigration assistance they arecommitting a criminal offence and may be prosecuted.Migration agents in AustraliaMigration agents in Australia must be registered with the Officeof the Migration Agents Registration Authority (Office of theMARA) unless they are exempt from registration.Migration agents outside AustraliaMigration agents who operate outside Australia do not have tobe registered. The department may give some overseas agentsan ID number. This number does not mean that they areregistered.Note: Some Australian registered migration agents operateoverseas.Migration agent informationA migration agent is someone who can:• advise you on the visa that may best suit you;• tell you the documents you need to submit with yourapplication;• help you fill in the application and submit it; and• communicate with the department on your behalf.If you appoint a migration agent, the department will assumethat your migration agent will be your authorised recipient,unless you indicate otherwise.Your migration agent will be the person with whom thedepartment will discuss your application and from whom it willseek further information when required.You are not required to use a migration agent. However, if youuse a migration agent, the department encourages you to usea registered migration agent. Registered agents are bound bythe Migration Agents Code of Conduct, which requires them toact professionally in their clients’ lawful best interests.Information on migration agents, including a list of registeredmigration agents, is available on the Office of the MARA websitewww.mara.gov.auYou can also access information about migration agents on thedepartment’s website www.immi.gov.auExempt personsThe following people do not have to be a registered migrationagent in order to provide immigration assistance, but they mustnot charge a fee for their service:• a close family member (spouse, de facto partner, child,parent, brother or sister);• a member of parliament or their staff;• an official whose duties include providing immigrationassistance (eg. a Legal Aid provider);• a member of a diplomatic mission, consular post orinternational organisation.1208 (Design date 03/13) - Page 4 © COMMONWEALTH OF AUSTRALIA, 2013

Appointing a migration agent/exempt personTo appoint a migration agent/exempt person you shouldcomplete Part F Options for receiving written communications.Your migration agent/exempt person should complete form 956Advice by a migration agent/exempt person of providingimmigration assistance.Form 956 is available from the department’s websitewww.immi.gov.au/allforms/Options for receiving written communicationsIf you do not appoint a migration agent/exempt person youmay still authorise another person, in writing, to receive writtencommunications on your behalf. This person is called theauthorised recipient.Authorised recipient informationAll written communication about your application will be sent toyour authorised recipient, unless you indicate that you wish tohave health and/or character information sent directly to you.The department will communicate with the most recentlyappointed authorised recipient as you may only appoint oneauthorised recipient at any time for a particular application.You will be taken to have received any documents sent to thatperson as if they had been sent to you.To appoint an authorised recipient you should complete:• Part F Options for receiving written communications; and• form 956A Appointment or withdrawal of an authorisedrecipient.Note: Migration agents/exempt persons do not need tocomplete form 956A.Form 956A is available from the department’s websitewww.immi.gov.au/allforms/Consent to communicate electronicallyThe department may use a range of means to communicatewith you. However, electronic means such as fax or e-mail willonly be used if you indicate your agreement to receivingcommunication in this way.To process your application the department may need tocommunicate with you about sensitive information, for example,health, police checks, financial viability and personalrelationships. Electronic communications, unless adequatelyencrypted, are not secure and may be viewed by others orinterfered with.If you agree to the department communicating with you byelectronic means, the details you provide will only be used bythe department for the purpose for which you have providedthem, unless there is a legal obligation or necessity to use themfor another purpose, or you have consented to use for anotherpurpose. They will not be added to any mailing list.The Australian Government accepts no responsibility for thesecurity or integrity of any information sent to the departmentover the internet or by other electronic means.If you authorise another person to receive documents on yourbehalf and they wish to be contacted electronically, theirsignature is required on form 956 or 956A to indicate theirconsent to this form of communication.Note: Electronic communication is the fastest means ofcommunication available and the department prefers tocommunicate electronically because this results in fasterprocessing.About the information you giveThe department is authorised to collect information providedon this form under Part 2 of the Migration Act 1958 ‘Control ofArrival and Presence of Non-Citizens’. The information providedwill be used for assessing your eligibility for a visa to visitAustralia.The information provided might also be disclosed to agencieswho are authorised to receive information relating to adoption,border control, business skills, citizenship, education, healthassessment, health insurance, health services, law enforcement,payment of pensions and benefits, taxation, superannuation,review of decisions and registration of migration agents.Relevant information about you will be disclosed to federal,state and territory police to assist in your location and possibledetention in the event that you become an unlawful non-citizen.You will become an unlawful non-citizen if your visa ceases (bycancellation for breach of visa condition for example) or expiresand you do not hold another visa authorising you to remain inAustralia.The collection, access, storage, use and disclosure by thedepartment of the information you provide in this form isgoverned by the Privacy Act 1988 and, in particular, by the11 Information Privacy Principles. The information form 993iSafeguarding your personal information, available from officesof the department, gives details of agencies to which yourpersonal information might be disclosed.The information provided on this form, including anyinformation on your health, will be used to assess your healthfor an Australian visa and may be disclosed to the relevantCommonwealth, state and territory health agencies andexamining doctor(s).Form 1163i Health requirement for temporary entry toAustralia provides additional information on Australia’s visahealth requirements. Form 1163i is available at offices of thedepartment or from the department’s websitewww.immi.gov.au/allforms/The department is authorised under the Migration Act 1958, incertain circumstances, to collect a range of personal identifiersincluding a facial image, fingerprints and a signature from noncitizens,including from visa applicants. The department requirespersonal identifiers to assist in assessing your identity. Thedepartment is authorised to disclose your personal identifiersand information relating to your name and other relevantbiographical data to a number of agencies including lawenforcement and health agencies and to other agencies whomay need to check your identity with this department. Wherethe department obtains personal identifiers they will becomepart of your official record with the department.The department is involved in international informationexchanges with a number of countries, including the UnitedKingdom, the United States of America, Canada and NewZealand. These international information exchanges may involvethe sharing of personal identifiers, including facial images andfingerprint data, collected by immigration agencies such as thisdepartment. If, as a result of this sharing between countries,there is a match with your personal identifiers, the departmentwill disclose your biographical data, copies of travel and otheridentity documents or information from such documents, yourimmigration status and immigration history (which may includeany immigration abuse and offences) and any criminal historyinformation relevant to immigration purposes. The purpose ofsuch disclosure would be to help confirm your identity anddetermine if you have presented to the department and theother agency under the same identity and with similar claims.© COMMONWEALTH OF AUSTRALIA, 20131208 (Design date 03/13) - Page 5

For more detailed information you should read informationform 1243i Your personal identifying information, which isavailable from the department’s websitewww.immi.gov.au/allforms/ or from any office of thedepartment or Australian mission overseas.A list of offices of the department in Australia is availablefrom www.immi.gov.au/contacts/Further information about the Working Holiday visa isavailable from www.immi.gov.au/visitors/Application checklistThis checklist is provided for your assistance and lists therequired and optional documents to include with yourapplication. It is not a requirement of your application.Note: Processing of your application will be delayed if you donot provide all the required information and documents at thetime of lodgement.Note: Certified copies are copies authorised, or stamped asbeing true copies or originals, by a person or agency recognisedby the law of the country in which you currently reside.Note: If your documents are in a language other than English,translations into English must be provided.TICK✓when completed.A certified copy of the pages of your passportcontaining your photo and personal details(Note: Your passport preferably should be validfor at least 6 months).The Visa Application Charge (for the currentWork and Holiday Visa Application Charge, seeform 990i Charges, available fromwww.immi.gov.au/allforms/pdf/990i.pdf )For payment options, see Method of paymenton page 3 of this application.If you are authorising another person to actand receive communications on your behalf,complete Part F Options for receiving writtencommunications on page 11 and form 956Appointment of a migration agent or exemptagent or other authorised recipient.If you are from:• Argentina;• Bangladesh;• Chile;• Indonesia;• Malaysia;• Thailand;• Turkey; or• Uruguayan original letter of approval from yourgovernment.If you are from:• Argentina;• Bangladesh;• Chile;• Indonesia;• Malaysia;• Thailand;• Turkey; or• Uruguayproof of English proficiency.Home pageGeneralenquiry linePlease keep these information pages for your referencewww.immi.gov.auTelephone 131 881 during business hoursin Australia to speak to an operator (recordedinformation available outside these hours).If you are outside Australia, please contactyour nearest Australian mission.1208 (Design date 03/13) - Page 6 © COMMONWEALTH OF AUSTRALIA, 2013

Application for a Work and Holiday visaForm1208Please use a pen, and write neatly in English using BLOCK LETTERS.Tick where applicable12Part A – Your detailsYour full name, exactly as it appears on the passport on which you willbe travelling to AustraliaFamily nameGiven namesHave you been known by any other names?(including name at birth, previous married names, aliases)NoYes✓Note: Any reference in this form to ‘country’ refers to ‘foreign country’ whichis defined in paragraph 22(1)(f) of the Acts Interpretation Act 1901 as anycountry (whether or not an independent sovereign state) outside Australia andthe external territories.Give details7Details from your passportPassport numberCountry ofpassportDate of issueDate of expiryIssuing authority/Place of issue asshown in yourpassportDAY MONTH YEARIf you hold more than one passport please provide details ofthose passportsYour full name as it appears in the passportFamily nameGiven namesPassport numberCountry ofpassportDate of issueDAY MONTH YEARDate of expiry3 Sex Male Female456Date of birthPlace of birthTown/cityCountryRelationship statusMarriedEngagedDe factoDAY MONTH YEARSeparatedDivorcedWidowedNever married orbeen in a de factorelationship8Issuing authority/Place of issue asshown in yourpassportNote: Visa applicants must hold a valid passport to be granted a visa. Itis recommended that the passport be valid for at least 6 months.If you change your passport after you have been granted the visa youmust notify the nearest Australian mission, Visa Application Centre oroffice of the department.If you do not provide the department with the details of any newor additional passport you use to travel to Australia, you willexperience significant delays at the airport and could be deniedpermission to board your plane.Do you hold any citizenship other than that shown asyour country of passport above?NoYesGive details9Details of identity card or identity number issued to you by yourgovernment (if applicable) eg. National identity card.Note: If you are the holder of multiple identity numbers because you area citizen of more than one country, you need to enter the identity numberon the card from the country that you live in.Identity numberCountry of issue© COMMONWEALTH OF AUSTRALIA, 20131208 (Design date 03/13) - Page 7

10Usual occupation11 What type of employment do you intend to seek during your stay?17 Do you agree to the department communicating with you by fax,e-mail, or other electronic means? (Providing an e-mail address willallow for more efficient processing of your application)NoYesGive detailsCOUNTRY CODEAREA CODENUMBER12QualificationsFax number ( )( )E-mail addressPlease ensure you have access to this e-mail while your applicationis being processed13 If you are from Argentina, Bangladesh, Chile, Indonesia, Malaysia,Thailand, Turkey or Uruguay, please provide evidence of how youobtained your English language proficiencyCompleted a diploma or degree and the tuition was in EnglishPassed an International English Language Testing System (IELTS)test and achieved at least 4.5 pointsOtherGive details181920DAY MONTH YEARDate of proposed travel to AustraliaNote: You must enter Australia within 12 months from the date the visais granted.Do you have sufficient funds for the initial period of your stay in Australia?Note: You may be asked to provide evidence (eg. bank statement).NoYesDo you have a return or onward ticket or the funds for a fare to departAustralia?Note: You may be asked to provide evidence.NoYes21Do you have any dependent children that will accompany you to Australia?Note: You cannot be accompanied by dependent children on this visa.14Current residential address(If applying in Australia, please give your current address in Australia)Note: A post office box address is not acceptable as a residentialaddress. Failure to give a residential address will result in your applicationbeing invalid.22NoYesPart B – Previous applicationsHave you previously been to Australia, applied for a visa, held or currentlyhold a visa for travel to Australia (including a Working Holiday (417) orWork and Holiday (462) visa)?POSTCODENo15Address for correspondence(This may be required by the department to communicate with youabout your application. If the same as your residential address, write‘AS ABOVE’)YesGive details including type of visa(s), place(s) ofapplication and date(s) of entry to Australia (if applicable)POSTCODE16Your telephone numbersOffice hoursCOUNTRY CODE AREA CODE( ) ( )NUMBERAfter hoursMobile/cell( ) ( )23Have you previously had an Australian visa cancelled, been detainedin Australia, removed or deported from Australia, or refused entryinto Australia?NoYesGive details1208 (Design date 03/13) - Page 8 © COMMONWEALTH OF AUSTRALIA, 2013

24Please provide the contact details of a relative, friend or a person youknow in Australia27Do you intend to work as, or study to be, a doctor, dentist, nurse orparamedic during your stay in Australia?Relationshipto youFamily nameNoYesGive detailsGiven namesAddressTelephone numbersOffice hours(AREA CODE )POSTCODE28Do you intend to work, or be a trainee, at a child care centre (includingpreschools and creches) while in Australia?NoYes Give detailsAfter hours (AREA CODE )Mobile/cell25Part C – Health detailsIn the last 5 years, have you visited, or lived, outside your country ofpassport for more than 3 consecutive months?NoYes Give details29Do you intend to be in a classroom situation for more than 3 months(eg. as either a student, teacher, lecturer, or observer)?NoYes Give details1.Country(s)DatefromDAY MONTH YEAR DAY MONTH YEARto2.Country(s)30Have you:DatefromDAY MONTH YEAR DAY MONTH YEARto• ever had, or currently have, tuberculosis?• been in close contact with a family member that has activetuberculosis?3.Country(s)• ever had a chest x-ray which showed an abnormality?DatefromDAY MONTH YEAR DAY MONTH YEARtoNoYesGive details26Do you intend to enter a hospital or a health care facility (includingnursing homes) while in Australia?NoYes Give details© COMMONWEALTH OF AUSTRALIA, 20131208 (Design date 03/13) - Page 9

31 During your proposed visit to Australia, do you expect to incur medicalcosts, or require treatment or medical follow up for:• blood disorder;• cancer;• heart disease;• hepatitis B or C and/or liver disease;• HIV infection, including AIDS;• kidney disease, including dialysis;• mental illness;• pregnancy;• respiratory disease that has requiredhospital admission or oxygen therapy;• other?NoYes Give details3233Do you require assistance with mobility or care due to amedical condition?NoYes Give detailsDo you hold health insurance to cover your stay in Australia?Note: See page 2 of this form for further information about healthinsurance.NoYesPart D – Character details34 Have you ever:• been convicted of a crime or offence inany country (including any conviction whichis now removed from official records)?• been charged with any offence that iscurrently awaiting legal action?• been acquitted of any criminal offence orother offence on the grounds of mentalillness, insanity or unsoundness of mind?• been removed or deported from anycountry (including Australia)?• left any country to avoid being removedor deported?• been refused a visa for Australia or anothercountry?• been excluded from or asked to leave anycountry (including Australia)?• committed, or been involved in thecommission of war crimes or crimesagainst humanity or human rights?• been involved in any activities that wouldrepresent a risk to Australian nationalsecurity?• had any outstanding debts to theAustralian Government or any publicauthority in Australia?• been involved in any activity, or beenconvicted of any offence, relating to theillegal movement of people to any country(including Australia)?• served in a military force or statesponsored/private militia, undergone anymilitary/paramilitary training, or beentrained in weapons/explosives use(however described) other than in thecourse of compulsory military service?If you answered ‘Yes’ to any of the above questions you must give allrelevant details in the space provided below.If the matter relates to a criminal conviction, please give the nature ofthe offence, full details of sentence, dates of any period of imprisonmentor other detention and a personal account of the events leading up toand including the offence(s)NoNoNoNoNoNoNoNoNoNoNoNoYesYesYesYesYesYesYesYesYesYesYesYesIf insufficient space attach a separate sheet1208 (Design date 03/13) - Page 10 © COMMONWEALTH OF AUSTRALIA, 2013

Part E – Assistance with this formPart G – Payment details35Did you receive assistance in completing this form?40Do you have the application charge to include with your application?NoYesTitle:Go to Part FPlease give details of the person who assisted youMr Mrs Miss Ms OtherNote: To check the Visa Application Charge, see form 990i Chargesavailable from the department’s websitewww.immi.gov.au/allforms/990i.htm or check with the nearest officeof the department.Family nameGiven namesNoYesThis application will be returned to you as a valid applicationwill not have been madeAddressTelephone number or daytime contactOffice hoursMobile/cellCOUNTRY CODE AREA CODE( ) ( )POSTCODENUMBER41 How will you pay your application charge?If applying outside Australia, please check with the AustralianGovernment office or Visa Application Centre where you intend to lodgeyour application as to what methods of payment and currencies they canaccept and to whom the payment should be made payable.Bank chequeMoney orderDebit cardCredit cardCannot be used for applications lodged by mailGive details below36Is the person an agent registered with the Office of the Migration AgentsRegistration Authority (Office of the MARA)?NoYes Go to Part FPayment by (tick one box)MasterCard Diners ClubAmerican ExpressJCBVisaAustralian DollarsAUD373839Is the person/agent in Australia?No Go to Part FYesDid you pay the person/agent and/or give a gift for this assistance?NoYesPart F – Options for receiving writtencommunicationsAll written communications about this application should be sent to:(Tick one box only)MyselfORAuthorisedrecipientORMigration agentORExempt personYou should complete form 956A Appointmentor withdrawal of an authorised recipientYour migration agent/exempt person shouldcomplete form 956 Advice by a migrationagent/exempt person of providingimmigration assistanceCredit card number: : : : : : : : : : : : : : : : : :Expiry dateCardholder’s nameTelephonenumberAddressSignature ofcardholderMONTH:COUNTRY CODEYEAR( ) ( ):AREA CODEPOSTCODENUMBERCredit card information will be used for charge paying purposes only.© COMMONWEALTH OF AUSTRALIA, 20131208 (Design date 03/13) - Page 11

Part H – Declaration and consent42WARNING: Giving false or misleading information is a serious offencePlease sign the declaration belowI declare that:• the information on this form is correct;• I have read the notes at the front of this application, and am awarethat I am required to abide by the conditions that are placed on myvisa;• after applying, I will notify the Department of Immigration andCitizenship of any change in my circumstances including my addressdetails; and• I will respect Australian values as listed on this form, during my stayin Australia and will obey the laws of Australia.For offshore applicants who are required to provide their fingerprintsand facial image:• I understand that my fingerprints and facial image and mybiographical information held by the Department of Immigration andCitizenship may be given to Australian law enforcement agencies tohelp identify me, to help determine my eligibility for grant of the visaI have applied for, and for law enforcement purposes.• I consent to:– Australian law enforcement agencies disclosing my biometric,biographical and criminal record information to the Department ofImmigration and Citizenship for any of the purposes outlinedabove; and– the Department of Immigration and Citizenship using theinformation obtained for the purposes of the Migration Act 1958or the Citizenship Act 2007.Signature ofapplicantDateDAY MONTH YEARPlease check all questions are answered. If your form isincomplete, there may be delays in processing your application.We strongly advise that you keep a copy of your applicationand all attachments for your records.1208 (Design date 03/13) - Page 12 © COMMONWEALTH OF AUSTRALIA, 2013