| Visa Questionnaire |
| Email: (*): |
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| Surname/Given Names (*): |
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| Phone No. |
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| Date of Birth (*): Please enter your date of birth in the format dd-mm-yyyy |
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| Gender (*): |
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| Place of Birth : |
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| Country of Citizenship (*): |
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| Visa : Do you have a preferred visa class under which you would like to be assessed or considered. Please list the visa class. |
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| Marital Status : |
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| Relatives : Do you or your spouse have any close relatives living in Australia. List their relationship and how long they have been living in Australia, Canada, UK, USA, New Zealand e.g. Cousin - 2 years |
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| Occupation: List your occupations over the last 4 years eg: Engineer 2002 - 2005 : |
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| Formal Education : Do you have any degrees, diplomas, trade qualifications. Please list accordingly |
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| Completion : Please list the dates you completed your tertiary studies, diploma or trade qualification and the institute where you studied. |
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| Spouse Details |
| Spouse's Name : |
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| Spouse's Date of Birth : Please enter your spouse's Date of Birth in the format dd-mmm-yyyy |
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| Spouse's Occupation |
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| Spouse's Qualifications: Does your Spouse have any degrees, diplomas, trade qualifications. Please list accordingly : |
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| Other Information |
| Study : Are you considering Studying in Australia, Canada, UK, USA, New Zealand etc. |
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| Business Owner: Are you a business owner, if so please give your designation and industry over the past 4 years. : |
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| Sponsored Employment : Do you know of a company that is willing to sponsor you to work in Australia, Canada, UK, USA, New Zealand. |
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| CV/Resume : You may send your CV/Resume should you have a saved copy on your computer. |
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| Further Information : Please add any other information that you feel would assist us. |
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