157a PDF
157a PDF
157a PDF
Review rights
If you apply for a student visa in Australia and you are refused
the visa, you may apply for a review of the decision. You will be
notified of your review rights in writing and the time limits for
lodging such an appeal.
There are no review rights for decisions to refuse a student visa
where the application is made outside Australia.
No Passport number
Date of expiry
6 Sex Male Female Issuing authority/Place of issue as shown in your passport
DAY MONTH YEAR
7 Date of birth
9 Marital status
Married Separated Widowed
Engaged Divorced Never married
De facto
1. Family name
15 Your country of usual residence
Given names
Date of birth
After hours ( ) ( )
Country of passport
Date of issue
Date of expiry
POSTCODE
Issuing authority/Place of issue as shown in passport
POSTCODE
No
Yes Give details
COUNTRY CODE AREA CODE NUMBER
Fax number ( ) ( )
E-mail address
Note: If this visa application is refused, you will be notified by mail
Date of birth 24 Do you have the sole legal right to determine where any dependants
Is this person included in this application? under 18 years of age who are included in this application will live or to
remove each such dependant from their country of usual residence?
No
No Give details below
Yes Details from passport
Yes Go to Question 25
Passport number
Give details of ALL other people not included in this application who have
Country of passport custody, access or guardianship rights in relation to the dependant(s).
Attach a statutory declaration from each of these people giving permission
for the dependant to accompany you to Australia.
DAY MONTH YEAR
Date of issue
Family name
Date of expiry
Given names
Issuing authority/Place of issue as shown in passport
Residential
address
POSTAL CODE
Does this person intend to study in No Yes COUNTRY CODE AREA CODE NUMBER
Australia for more than 3 months?
Telephone ( ) ( )
Relationship
Country of passport to dependant
Nature of
DAY MONTH YEAR
legal right
Date of issue Statutory declaration attached? No Yes
Date of expiry
25 Are any of your dependants who are under 18 years of age, and who
Issuing authority/Place of issue as shown in passport are included in this application, the subject of a court order giving you:
• the sole legal right to determine where they will live; or
• the right to remove them from their country of usual residence?
No
Does this person intend to study in No Yes
Australia for more than 3 months? Yes Attach a certified copy of the court order(s)
If granted a visa without a label, provide the 13-digit visa Highest qualification
grant number (as shown on the letter notifying you of
visa grant).
Name of education provider or training body
Name
Address of education provider or training body
Type of visa
Place of issue
DAY MONTH YEAR
POSTAL CODE
Date of issue
DAY MONTH YEAR
Name of education provider or training body Name of education provider or training body
From to
POSTAL CODE
Previous course in Australia
DAY MONTH YEAR
Commencement date
Name of education provider or training body
Finish date
Name of education provider or training body 32 Give details of your intended courses of study in Australia.
You must provide evidence of enrolment. Unless you are seeking to study
in Australia as a secondary school exchange student or as a student
Address of education provider or training body sponsored by AusAID or the Australian Department of Defence, you must
attach:
• if applying in Australia, or outside Australia as an Assessment
Level 1 or 2 student, the electronic confirmation of enrolment
POSTAL CODE certificate from your education provider. If you propose to study more
DAY MONTH YEAR than one course you must provide either an electronic confirmation
Commencement date of enrolment certificate, or an original ‘offer of a place in a course’
letter from your education provider for each additional course; or
Finish date • if applying outside Australia as an Assessment Level 3 or 4
student, the original ‘offer of a place in a course’ letter from your
Documentation attached? No Yes education provider. If you are assessed as a genuine student, the
Australian Government office will provide you with a letter of
31 Have you previously studied in Australia? genuineness. Only at this stage should you pay any tuition fees and
obtain an electronic Confirmation of Enrolment.
No
If you are seeking to study as an exchange student, you must attach to
Yes Give details below this application the Acceptance Advice Secondary Exchange Student
You must provide evidence of your studies and training, (AASES) form as evidence of enrolment.
including academic records If you wish to study in Australia as a student sponsored by AusAID or the
Australian Department of Defence, you must attach evidence of
Previous course in Australia sponsorship from AusAID or the Department of Defence.
Period of study
MONTH YEAR MONTH YEAR
Commencement date
Finish date
Period: From to
Name of education provider or training body Name and address of employer
Period: From to
Your English language details
Name and address of employer
33 Are you an applicant in Assessment Level 1 or 2?
No
Yes Go to Question 36 POSTAL CODE
Type of business
34 Have you undertaken an English language proficiency test within the last
24 months? Occupation
No Salary level
Yes Name of test
Documentation attached? No Yes
Date of test
Test certificate number
POSTCODE
Date of arrival
Name, address and telephone number of your employer
Name
Relationship
POSTAL CODE to you
DAY MONTH YEAR
COUNTRY CODE AREA CODE NUMBER
Date of birth
( ) ( )
Address
Have you attached evidence of your employment details?
No Yes
Are you currently a student in Australia?
POSTCODE
No Yes
Immigration status in Australia (eg. temporary or permanent resident,
Australian citizen)
38 Have you been offered a job for when you return home at the completion
of your course?
DAY MONTH YEAR
No What kind of employment will you be seeking on your
return to your home country? Date of arrival
40 Give details of your closest relative in your home country who is neither
accompanying nor joining you in Australia
Name
Relationship
to you
Yes Name, address and telephone number of your employer
Address
POSTAL CODE
POSTAL CODE
( ) ( )
Telephone ( ) ( )
Date
POSTCODE
Date granted
Expiry date
Note: You cannot join your family unit member in Australia on a student
visa if they are in Assessment Levels 3–5 unless the total duration of
the course(s) they are undertaking in Australia is at least 12 months or
more.
47 Did the student you are joining declare in their initial student visa
application you and other members of their family unit included in this
application?
No
Yes
No
Yes Give details
Name
Countries
DAY MONTH YEAR DAY MONTH YEAR
Date to
54 Do you require assistance with mobility and/or care?
Name No
Date to
Name
Countries
DAY MONTH YEAR DAY MONTH YEAR
Date to
51 Do you, or any member of your family unit included in this application, 55 Do you intend performing medical procedures (eg. as a practising/trainee
intend entering an Australian hospital (including nursing homes) for work, doctor, dentist, nurse) during your stay in Australia?
training, treatment or visiting? No
No Yes Provide details of the medical/dental/nursing procedures
Yes Give full details you may be involved with in Australia
No
Yes Give full details
You are strongly advised to carry certification of your vaccination status, • been involved in any activity, or been
especially for children attending Australian child care centres (including convicted of any offence, relating to the
preschools and creches) and schools. Vaccination against polio, tetanus, illegal movement of people to any country
(including Australia)? No Yes
measles, mumps, rubella, diphtheria, pertussis (whooping cough),
Haemophilus influenzae hypo B (Hib), and Hepatitis B is recommended • served in a military force or state
for children, with certification sought at time of child care centre (including sponsored/private militia, undergone any
preschool and creche) and school enrolment. Vaccination against rubella military/paramilitary training, or been
is also recommended for women of child bearing age. trained in weapons/explosives use
(however described)? No Yes
If you answered ‘Yes’ to any of the above questions, you must state
who it applies to and give ALL relevant details. If the matter relates to
a criminal conviction, please give the nature of the offence, full details
of sentence and dates of any period of imprisonment or other detention.
If insufficient space, attach an additional statement.
are under 18 years of age. If your parents or a person(s) who Date of birth
has legal custody of you have not made adequate
arrangements for your accommodation, support and general Your intended address in Australia
welfare while in Australia, a student visa cannot be granted.
Evidence of their relationship to you must be provided.
POSTCODE
59 This question, and other questions as indicated, must be completed
by the parents, or person(s) who has legal custody of the Application:
applicant under 18 years of age. Granted Visa label number
Which statement best explains your situation? V <
I am a parent or person who has legal If granted a visa without a label, provide the 13-digit
custody of the student applicant and I am visa grant number (as shown on the letter notifying
going to accompany the child to Australia. Go to Question 60 you of visa grant).
Family name
Given names
Date of birth
POSTCODE
Date
You must attach evidence:
• that your relative is of good character eg. police clearance; and Full name (print in English)
Date
Not yet Australian Government office where application
decided lodged Full name (print in English)
Now go to Question 65
Continued on the next page
64 As the parents or a person(s) who has legal custody of a student applicant
under 18 years of age, who is neither being accompanied by you nor
staying with a relative who is at least 21 years of age, have you obtained
a written statement from your child’s education provider(s) that
accommodation, support and general welfare arrangements for your child
are appropriate?
No
Yes Please attach the original signed undertaking from the
education provider
Date
( ) ( )
All other people who have custody, access or guardianship Full name (print in English)
rights in relation to the applicant must also sign the
declaration at Question 67.
Relationship to student applicant
If any of these people are unable to complete the declaration
at Question 67 for any reason, you must attach a statutory
declaration from them giving permission for the applicant to If more than 2 people have custody, access or guardianship rights in
travel to Australia as a student. relation to the applicant, please attach a statutory declaration from them
giving permission for the applicant to travel to Australia as a student.
Yes Complete the declaration at Question 67
Yes Please give details of the person who assisted you A$ AND/OR
What kind of gift did you give? (eg. jewellery)
Title: Mr Mrs Miss Ms Other
Address
Options for receiving written
communications
POSTCODE
Yes Please give details below Authorised This is a person authorised to only receive
recipient
Education Agency Business Name written communications. All written
communications that would otherwise
have been sent to you in relation to this
Education Agent Registration Number (if known) application will be sent to that person.
( ) ( )
Mobile phone
Fax number
COUNTRY CODE AREA CODE NUMBER
( ) ( )
Family name
Given names
POSTCODE
Business or
Telephone number or daytime contact company name
COUNTRY CODE AREA CODE NUMBER
Postal address
Office hours ( ) ( )
Mobile phone
POSTCODE
authorised
recipient E-mail address
Date
MasterCard Visa
Bankcard Diners Club A$
American Express JCB
MONTH YEAR
Expiry date : :
Cardholder’s name
Telephone ( ) ( )
Address
POSTCODE
Signature of
cardholder
Credit card information will be used for charge paying purposes only.
82 The following declaration must be signed and dated by all people over Signature
18 years of age included in this application.
Both parents or any person who has legal custody must complete the DAY MONTH YEAR
declaration on behalf of any children under 18 years of age or any person Date
who lacks the legal capacity to sign on their own behalf.
• I certify the information supplied on or with this form is correct.
• If granted a visa, I acknowledge that I am required to abide by its Signature
conditions as outlined in the information form 1160i Applying for a
student visa.
DAY MONTH YEAR
• I declare that I have made adequate arrangements for health insurance
Date
for the period of my stay in Australia and I acknowledge that I am
required to maintain these arrangements while in Australia as the
holder of a student visa.
• I have attached all documentary evidence as specified on the Signature
department’s website for my Assessment Level and the visa subclass
under which I am applying. DAY MONTH YEAR