GENERAL INFORMATION FORM

PERSONAL DETAILS
Title
Family Name
Given Name
Middle Name
Date of Birth
Gender Prefer not to say
Citizenship
Country of Birth
Country of Passport
Passport Number
Marital Status Single
Which country are you
applying from?

CONTACT DETAILS
Email Address
Mobile number
Complete Home address

Zip/Postal Code
Emergency Contact a. Complete Name:
b. Relationship to the applicant:
c. Contact number:
d. Email Address:

VISA DETAILS AND HISTORY

Are you currently in No
Australia?
Yes
(If Yes, please answer the questions below)
a. Current address in Australia:

b. Current Visa type:

c. Current Visa Expiry date:
d. When did you first arrive in Australia?

Do you intend to apply for an Yes No

Australian Student Visa? (If Yes, please answer the questions below)
 a. Do you intend to bring any dependents? Yes No
If yes, are you bringing your partner/spouse? Yes No
If yes, are you bringing your child/children? Yes No
Have you ever been excluded Yes No
from an Australian education (If Yes, please provide details and documentation)
institution before?

Have you, or a member of Yes No

your immediate family ever (If Yes, please provide details and documentation)
overstayed your visa, or had a
visa refused or cancelled in
any country?
Do any immediate family Yes No
members reside outside of (If Yes, please specify location and number of family members)
your home country?

Have you previously visited or Yes No

studied in Australia? (If Yes, please answer the question below)

Have you breached any visa conditions previously? Yes No

(If Yes, please provide details)

Have you or a family member Yes No

ever been refused a visa for (If Yes, please provide details and documentation)
entry into Australia or any
other country?
Have you or a family member Yes No
ever breached any visa (If Yes, please provide details and documentation)
conditions of any other
country?

Declara�on:
I declare that the pieces of informa�on provided are true and correct in every detail.

Name of Applicant:
Signature:
Date: