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ENQUIRY FORM

Personal Details

Family Name:

First Name:

Middle Name:

Date of Birth:

Citizen of:

Residential Address:

Email:

Mobile Phone:

(Please include country & area code)

Documentation

Passport No:

Passport Expiry:

Visa type held:

Visa Expiry:

Date your visa was applied for:

Dependent

Marital Status:

Spouse details:

Name of Spouse:

Spouse DOB:

Country of current residence :

For how many months have you been in this relationship?:

Dependent Children:

	Name:	DOB
Child 1:
Child 2:
Child 3:

Do you have ANY other children from a previous marriage or relationship?

Do you have any person over the age of 25 years who is dependent upon you?

Do you or does your spouse have any close relative(s) in Australia?

Who and where do these relatives live in Australia?
Please indicate name, state and suburb OR town.

	NAME	SUBURB or TOWN, STATE
1:
2:

Education
(Start from most recent post-secondary vocational or tertiary qualification)

	Educator	Academic award	Date commenced	Date completed
1
2
3
4

Employment:
(Start from the recent employment)

	Employer	City, country	Position title	Date commenced	Date completed
1
2
3
4

English Language:

Have you completed an English test?

What was the date of the most recent IELTS test:

What were the individual IELTS band scores? And the overall score?

Listening:

Reading:

Writing:

Speaking:

Overall:

Health:

Do you currently suffer from or have you suffered from any significant
medical conditions?

Does any member of your family or any child of yours from a previous relationship
suffer from any significant medical condition?

Character:

Have you or any member of your immediate family ever been convicted of ANY criminal offence in any country?

Australian Visa:

Have you or any member of your immediate family been REFUSED an Australian visa
OR had an Australian Visa CANCELLED?

Military Service or Intelligence Agency:

Have you or any member of your immediate family ever served in the military forces
of any country OR been employed by an intelligence agency in any country?

I certify that the answers I have given on this Client Questionnaire are true and correct

ENQUIRY FORM

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