Professional Documents
Culture Documents
Visa Type
Expiry Date: Page 1 of 23
DIBP:
Lodgment date:
Student Visa Subclass 500 ‐ Application Checklist
1. Current location
Give details of your current location.
Current location
2. Application type
Is this the first time the applicant is applying for a student visa?
Yes No
If you currently hold a student visa, please enter the details below:
Student visa number:
Student visa expiry date:
3. Confirmation of enrolment
List any current COEs you have from another provider (if you have any COE not from Envirotech):
5. Education Section
Select the education sector for the courses you are applying for:
VET
ELICOS
6. Commonwealth funded student
Did you receive partial or full funding under a training scheme approved by the Commonwealth
government of Australia, give details below:
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7. Primary applicant
Information: Entering names incorrectly may result in denial of permission to board an aircraft to Australia, or
result in delays in border processing on arrival in Australia, even if the applicant has been granted a visa.
7.1. Passport details
Enter the following details as they appear in the applicant's passport.
Family name
Given names
Sex
Male Female Other
Date of birth (dd/mm/yyyy)
Passport number
Country of passport
Nationality of passport holder
Date of issue (dd/mm/yyyy)
Date of expiry (dd/mm/yyyy)
Place of issue / issuing
authority
It is strongly recommended that the passport be valid for at least six months.
7.2. Place of birth
Town / City
State / Province
Country of birth
7.3. Relationship status
Relationship status -
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7.4. Other names / spellings
List all other names that you currently, or ever been known by:
First Name Family Name Reasons for Change
7.5. Citizenship
Is this applicant a citizen of the country of passport?
Yes No
List any other country the primary applicant is a citizen of:
7.6. Other passports
Does this applicant have other current passports?
Yes No
If yes, enter the following details as they appear in the applicant's passport.
Family name
Given names
Sex
Male Female Other
Date of birth (dd/mm/yyyy)
Passport number
Country of passport
Nationality of passport holder
Date of issue (dd/mm/yyyy)
Date of expiry (dd/mm/yyyy)
Place of issue / issuing authority
7.7. National identity documents
List any national identity documents held by the primary applicant
Please provide details of any of the following: Alien registration number, Birth certificate, Drivers
licence, Marriage certificate, National Identity document, or Social security card
Type of document Document number Country of document
7.8. Health examination
Has this applicant undertaken a health examination for an Australian visa in the last 12 months?
Yes No If yes, please provide details below:
8. Accompanying family members ‐ any family members included in this application, if applicable:
Dependent Applicant 1
Relationship to applicant and family status
Relationship to applicant Step Child
(Child, partner)
Family Status -Never married, Married, divorced, De‐facto, Widow
Passport Details
Family Name
Given Name
Sex
Date of birth (dd/mm/yyyy)
Passport Number
Country of Passport
Nationality of passport holder
Date of issue (dd/mm/yyyy)
Date of expiry (dd/mm/yyyy)
Place of issue / issuing authority
Is this family member a citizen of the country of passport?
Place of birth:
Town / City
State / Province
Country of birth
Other names / spelling of your name
Full Name Reason for change
Citizenship in any other countries
Country From date (dd/mm/yyyy)
Other Passports
Country of passport Name on passport Issue Date Expiry Date Issuing authority
National Identity documents
Type of document Document number Country
Health Examination, for an Australian visa in the last 12 months?
Medical exam date Name of Medical centre Location For what visa
Child custody details
Is the family member a child under 18 years of age? -Yes/ no
If yes, is this child in the primary applicant’s care and legal custody? -Yes/ no
Does any other person have custodial access or guardianship rights to the child? -Yes/ no
If yes, give details:
Are there any legal impediments to the child’s travel? -Yes/ no
If yes, give details:
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Dependent Applicant 2
Relationship to applicant and family status
Relationship to applicant Step Child
(Child, partner)
Family Status -Never married, Married, divorced, De‐facto, Widow
Passport Details
Family Name
Given Name
Sex
Date of birth (dd/mm/yyyy)
Passport Number
Country of Passport
Nationality of passport holder
Date of issue (dd/mm/yyyy)
Date of expiry (dd/mm/yyyy)
Place of issue / issuing authority
Is this family member a citizen of the country of passport?
Place of birth:
Town / City
State / Province
Country of birth
Other names / spelling of your name
Full Name Reason for change
Citizenship in any other countries
Country From date (dd/mm/yyyy)
Other Passports
Country of passport Name on passport Issue Date Expiry Date Issuing authority
National Identity documents
Type of document Document number Country
Health Examination, for an Australian visa in the last 12 months?
Medical exam date Name of Medical centre Location For what visa
Child custody details
Is the family member a child under 18 years of age? - Yes/ no
If yes, is this child in the primary applicant’s care and legal custody? - Yes/ no
Does any other person have custodial access or guardianship rights to the child? - Yes/ no
If yes, give details:
Are there any legal impediments to the child’s travel? - Yes/ no
If yes, give details:
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Dependent Applicant 3
Relationship to applicant and family status
Relationship to applicant Step Child
(Child, partner)
Family Status -Never married, Married, divorced, De‐facto, Widow
Passport Details
Family Name
Given Name
Sex
Date of birth (dd/mm/yyyy)
Passport Number
Country of Passport
Nationality of passport holder
Date of issue (dd/mm/yyyy)
Date of expiry (dd/mm/yyyy)
Place of issue / issuing authority
Is this family member a citizen of the country of passport?
Place of birth:
Town / City
State / Province
Country of birth
Other names / spelling of your name
Full Name Reason for change
Citizenship in any other countries
Country From date (dd/mm/yyyy)
Other Passports
Country of passport Name on passport Issue Date Expiry Date Issuing authority
National Identity documents
Type of document Document number Country
Health Examination, for an Australian visa in the last 12 months?
Medical exam date Name of Medical centre Location For what visa
Child custody details
Is the family member a child under 18 years of age? -Yes/ no
If yes, is this child in the primary applicant’s care and legal custody? -Yes/ no
Does any other person have custodial access or guardianship rights to the child? -Yes/ no
If yes, give details:
Are there any legal impediments to the child’s travel? -Yes/ no
If yes, give details:
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Contact details
9. Department office
You may be required to attend an Australian Government Office for an interview. Which is the closest office to
the applicant’s current location?
The nearest DIBP Office is
10. Country of residence (For student visa this should be the applicant’s home country)
Usual country of residence
11. Residential address in usual country of residence
Note that a street address is required. A post office address cannot be accepted as a residential address.
Country
Address
Suburb / Town
State or Province
Postal code
12. Contact telephone numbers in usual country of residence
Business phone
Home phone
Mobile / Cell phone
13. Residential address in Australia
Give details of your residential address in Australia (if known). Note that a street address is required. A post
office address cannot be accepted as a residential address.
Country
AUSTRALIA
Address
Suburb / Town
State or Province
Postal code
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14. Contact telephone numbers in Australia
Business phone
Home phone
Mobile / Cell phone
15. Postal address for correspondence
Postal address for correspondence
Country
Address
Suburb / Town
State or Province
Postal code
16. Email address
Email address
17. Authorised recipient
Provide details of any person you wish to authorised to receive written correspondence on the student behalf
This person will be referred to as the 'authorised recipient'.
MARN/Education Contact
Postal Email
agent number Family name Given name Organisation telephone
Address address
(if applicable) number/s
18. Other family members
List all your other family members (not partners or children), e.g.: parents or siblings both in and outside of Australia
19. Non‐accompanying family members
If you have any family members (partner or children) not already included as an 'Accompanying family member'
in this application, then Provide details of these non‐accompanying family members:
Please note that if these non-accompanying family unit member's details are not included in this
application, they will not be eligible for grant of a student visa at a later date.
Dependent Applicant 1
Relationship to applicant and family status
Relationship to applicant -(Child, partner)
Family Status -Never married, Married, divorced, De‐facto, Widow
Personal Details
Family Name
Given Name
Sex
Date of birth (dd/mm/yyyy)
Place of birth:
Town / City
State / Province
Country of birth
Other names / spelling of your name
Full Name Reason for change
Citizenship in any other countries
Country From date (dd/mm/yyyy)
Passports
Country of passport Name on passport Issue Date Expiry Date Issuing authority
National Identity documents
Type of document Document number Country
Health Examination, for an Australian visa in the last 12 months?
Medical exam date Name of Medical centre Location For what visa
Child custody details
Is the family member a child under 18 years of age? -Yes/ no
If yes, is this child in the primary applicant’s care and legal custody? - Yes/ no
Does any other person have custodial access or guardianship rights to the child? - Yes/ no
If yes, give details:
Are there any legal impediments to the child’s travel? -Yes/ no
If yes, give details:
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20. Genuine temporary entrant
All student visa applicants are required to provide information in support of their application to demonstrate that
they meet the Genuine Temporary Entrant criteria.
I declare that I have satisfied the following criteria:
Reasons for choosing to undertake the specified courses are provided
Reasons for choosing Envirotech as education provider are provided
Reasons for choosing to study in Australia rather than in a home country/usual country of residence
were given
Financial capacity requirements are met and documentary evidence is provided
Genuine access to funds demonstrated to meet the first year of study and living expenses:
‐ Student – AUD 19830
‐ Partner/Spouse – AUD 6940
‐ Child – AUD 2970
‐ Return Ticket
‐ Tuition Fees
Student meet the English language requirements for the entry to the chosen course fulfilled
Relevance of courses to student academic/employment background have been demonstrated
Relevance of courses to the student future career/educational plans
The student can demonstrate a genuine intention to stay in Australia temporarily
The student demonstrated circumstances in home country, potential circumstances in Australia,
value of the course to the future that satisfies intention to be a Genuine Student
If the student had previously traveled to Australia, the reason for that travel and the duration of stay
is provided
Student demonstrates knowledge in their course content and the individual units in the course
IMPORTANT Give details to support the ability to meet the criteria and demonstrate each of the areas listed
above. Ensure supporting documents are attached to support a positive student visa outcome.
You will have to provide this information to the Department of Immigration and Border Protection (DIBP) during
your student visa application. Please record your statement of meeting the GTE criteria below:
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21. Funding for stay
Do all applicants in this application confirm that they each have access to sufficient funds to support themselves
for the total period of stay in Australia and understand that further evidence of funds may also be requested?
Yes No
Show how each applicant included in the application will support themselves in Australia to meet living, tuition
and school costs. Select any that apply.
Funding type:
Government scholarship / financial support
Other organisation scholarship / financial support
Financial support from an individual
Other financial support - if you will support yourself , please provide details in Q.22
Yes No
23. Overseas Student Health Cover
Did you request Envirotech to arrange your Overseas Student Health Cover (OSHC)?
Yes No
If not, provide the following OSHC details:
Name of health insurer _________________________________________________________________
Insurance policy number _________________________________________________________________
Date from (dd/mm/yyyy) ____________________
Date to (dd/mm/yyyy) ____________________
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25. Education – give details of all your current and past education history, starting from high school
Status (Enrolled,
Full Name of Institution Completed, Date “From” Date “to”
Qualification level Course Name Campus/address of Institution Country
(no abbreviations) not‐completed, (dd/mm/yyyy) (dd/mm/yyyy)
withdrawn)
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26. Future employment
Are you offered a job at the completion of your course?
Yes No
Organisation name
Industry type
Organisation street address (A post office address cannot be accepted):
Country
Address
Suburb / Town
State or Province
Postal code
Contact person details
Give details of the contact person within the organisation.
Family name
Given names
Business phone
Mobile / Cell phone
Position details
Position
27. Language ability – Primary Applicant
27.1. Language Ability – English Test
Did you undertake an English language test within the last 24 months?
Yes No
If “YES” give details of the English test highest scoring English test over the 24‐month period.
Name of test
Date of test
Test reference number
Country where test was undertaken
Overall test score
27.2. Main language
Your main language
27.3. Study in English language
Did you successfully complete at least five years’ study (in the English language) in Australia, Canada, New
Zealand, Republic of South Africa, Republic of Ireland, United Kingdom and/or United States of America?
Yes No
In the two years before applying for the Student visa, has the applicant successfully completed the
requirements for a Senior Secondary Certificate of Education (conducted in English in Australia)?
Yes No
In the two years before applying for the Student visa, has the applicant successfully completed a substantial
component of a course leading to a qualification from the Australian Qualifications Framework at Certificate IV
or higher as a holder of a Student visa (conducted in English in Australia)?
Yes No
28. Language ability – Dependent Applicants
Dependent Applicant 1 main language
Dependent Applicant 2 main language
Dependent Applicant 3 main language
Dependent Applicant 4 main language
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29. Countries visited
Have any of the applicants visited any countries in the past 10 years? Include:
30. Australian Visa history
Has the applicant, or any person included in this application, held or currently hold a visa to Australia or any
other country?
Yes No
Entered Australia
Applicant name Australian Visa Type Grant Number Grant Date Expiry Date with this visa
(yes/no)
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31. Visa Declaration
Has the applicant, or any person included in this application, ever been in Australia or any other country and not
complied with visa conditions or departed outside their authorised period of stay?
Yes No
Has the applicant, or any person included in this application, ever had an application for entry or further stay in
Australia or any other country refused, or had a visa cancelled?
Yes No
32. Health declarations
In the last five years, has any applicant visited, or lived, outside their country of passport, for more than 3
consecutive months? Do not include time spent in Australia.
Yes No
Does any applicant intend to enter a hospital or a health care facility (including nursing homes) while in
Australia?
Yes No
Does any applicant intend to work as, or study to be a doctor, dentist, nurse or paramedic during their stay in
Australia?
Yes No
Does any applicant intend to work or be a trainee at a child care centre (including preschools and crèches) while
in Australia?
Yes No
Has any applicant:
ever had, or currently have, tuberculosis?
been in close contact with a family member that has active tuberculosis?
ever had a chest x‐ray which showed an abnormality?
Yes No
During their proposed visit to Australia, does any applicant expect to incur medical costs, 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 required hospital admission or oxygen therapy
other?
Yes No
Does any applicant require assistance with mobility or care due to a medical condition?
Yes No
33. Character declarations
Has any applicant ever been charged with any offence that is currently awaiting legal action?
Yes No
Has any applicant ever been convicted of an offence in any country (including any conviction which is now
removed from official records)?
Yes No
Has any applicant ever been the subject of an arrest warrant or Interpol notice?
Yes No
Has any applicant ever been found guilty of a sexually based offence involving a child (including where no
conviction was recorded)?
Yes No
Has any applicant ever been named on a sex offender register?
Yes No
Has any applicant ever been acquitted of any offence on the grounds of unsoundness of mind or insanity?
Yes No
Has any applicant ever been found by a court not fit to plead?
Yes No
Has any applicant ever been directly or indirectly involved in, or associated with, activities which would
represent a risk to national security in Australia or any other country?
Yes No
Has any applicant ever been charged with, or indicted for: genocide, war crimes, crimes against humanity,
torture, slavery, or any other crime that is otherwise of a serious international concern?
Yes No
Has any applicant ever been associated with a person, group or organisation that has been or is involved in
criminal conduct?
Yes No
Has any applicant ever been associated with an organisation engaged in violence or engaged in acts of violence
(including war, insurgency, freedom fighting, terrorism, protest) either overseas or in Australia?
Yes No
Has any applicant ever served in a military force, police force, state sponsored / private militia or intelligence
agency (including secret police)?
Yes No
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Has any applicant ever undergone any military/paramilitary training, been trained in weapons/explosives or in
the manufacture of chemical/biological products?
Yes No
Has any applicant ever been involved in people smuggling or people trafficking offences?
Yes No
Has any applicant ever been removed, deported or excluded from any country (including Australia)?
Yes No
as any applicant ever overstayed a visa in any country (including Australia)?
Yes No
Has any applicant ever had any outstanding debts to the Australian Government or any public authority in
Australia?
Yes No
Give Details:
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34. Student declarations
Warning: Giving false or misleading information is a serious offence.
The applicants declare that they:
Have read and understood the information provided on the website (www.studyinaustralia.gov.au) regarding living
and studying in Australia.
Yes No
Have access to sufficient funds to support themselves for the total period of stay in Australia. They also understand
that they may be requested to provide further evidence of funds.
Yes No
Have made adequate arrangements to health insurance for the period of their stay in Australia and acknowledge
they are required to maintain these arrangements while in Australia as the holder of a student visa.
Yes No
Understand that a student visa is a temporary visa and that being granted a student visa will not guarantee that they
will be eligible for the grant of a further visa to stay in Australia, including a skilled migration visa.
Yes No
Understand that if they cannot obtain a further visa they must depart Australia on or before the cease date of the
student visa.
Yes No
Acknowledge that if granted a student visa, they are required to understand and abide by its conditions.
Yes No
Understand that if the 8534 visa condition is imposed on the student visa, it will be indicated by the condition code
8534 and by the short description No Further Stay. They acknowledge that this means the 8534 condition has been
imposed on their visa and while in Australia they will only be entitled to the grant of limited visas including:
A subclass 485 (Temporary Graduate) visa, or
A subclass 590 (Student Guardian) visa.
Yes No
Understand that the effect of 8534 visa condition is that it will not be possible to apply to remain in Australia beyond
the date authorised on the student visa and that they will be required to depart Australia on or before that date.
Yes No
Understand that if the 8535 visa condition is imposed on the student visa, it will be indicated by the condition code
8535 and by the short description No Further Stay. They acknowledge that this means that the 8535 condition has
been imposed on their visa and while in Australia they will only be entitled to the grant of limited visas including:
A further student visa (subclass 500) in circumstance where the Commonwealth, or foreign government
(as the case requires), does not oppose them from obtaining a further visa to stay in Australia.
Yes No
Understand that the effect of the 8535 visa condition is that it will not be possible to remain in Australia beyond
the date authorised on the student visa, unless they are applying for a further student visa in circumstances where
the Commonwealth or a foreign government (as the case requires) does not oppose them undertaking a relevant
course of study, and that they will be required to depart Australia on or before the authorised date.
Yes No
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35. Declarations
Warning: Giving false or misleading information is a serious offence.
The applicants declare that they:
Have read and understood the information provided to them in this application.
Yes No
Have provided complete and correct information in every detail on this form, and on any attachments to it.
Yes No
Understand that if any fraudulent documents or false or misleading information has been provided with this
application, or if any of the applicants fail to satisfy the Minister of their identity, the application may be refused
and the applicant(s), and any member of their family unit, may become unable to be granted a visa for a specified
period of time.
Yes No
Understand that if documents are found to be fraudulent or information to be incorrect after the grant of a visa,
the visa may subsequently be cancelled.
Yes No
Understand that if this application is approved, any person not included in this application will not have automatic
right of entry to Australia.
Yes No
Will inform the Department of Immigration and Border Protection in writing immediately as they become aware
of a change in circumstances (including change of address) or if there is any change relating to information they
have provided in or with this application, while it is being considered.
Yes No
Have read the information contained in the Privacy Notice (Form 1442i).
Yes No
Understand that the department may collect, use and disclose the applicant's personal information (including
biometric information and other sensitive information) as outlined in the Privacy Notice (Form 1442i).
Yes No
Give consent to the collection of their fingerprints and facial image.
Yes No
Understand that, if required to provide their fingerprints and facial image, the applicant's fingerprints and facial
image and biographical information held by the Department of Immigration and Border Protection may be given
to Australian law enforcement agencies to help identify the applicant and determine eligibility for grant of the
visa being applied for, and for law enforcement purposes.
Yes No
Give consent to Australian law enforcement agencies disclosing the applicant's biometric, biographical and
criminal record information to the Department of Immigration and Border Protection to help identify the
applicant, to determine eligibility for grant of a visa and for law enforcement purposes.
Yes No
Give consent to the Department of Immigration and Border Protection using the applicant's biometric,
biographical and criminal record information obtained for the purposes of the Migration Act 1958 or the
Citizenship Act 2007.
Yes No
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36. Australian values
All persons included in this application who are 18 years or over have read, or had explained to them, information
provided by the Australian Government on Australian society and values and agrees to the Australian values
statement.
Yes No
List of required attachments:
• Evidence of English Language Proficiency (i.e. IELTS 5.5, TOEFL, PTE) – Please check your English
requirement through this link: https://www.border.gov.au/Trav/Stud/changes-english-requirements
• Financial Capacity evidence (Bank Statement, Sponsor Letter of Support, Sponsor ID)
• Form 956A (Please complete this form if you authorise Envirotech as 'authorised recipient')
Applicant Signature:
Date: