Application for a Student Guardian visa

Form

157G

Life in Australia Australian values

The Australian Government encourages people to gain an understanding of Australia, its people and their way of life, before applying for a visa to live in Australia. As part of this application every person aged 18 years or over must declare that they will respect Australian values, as outlined below and obey the laws of Australia. Australian values include respect for the freedom and dignity of the individual, freedom of religion, commitment to the rule of law, Parliamentary democracy, equality of men and women and a spirit of egalitarianism that embraces mutual respect, tolerance, fair play and compassion for those in need and pursuit of the public good. Australian society also values equality of opportunity for individuals, regardless of their race, religion or ethnic background. It is also important to understand that English is the national language. Further information is contained in the Life in Australia booklet, however, you are not required to read the booklet. The booklet is available in a wide range of languages. If you would like a copy of the booklet it can be obtained from www.immi.gov.au

Integrity of application
The Department of Immigration and Citizenship (the department) is committed to maintaining the integrity of the visa and citizenship programs. Please be aware that if you provide us with fraudulent documents or claims, this may result in processing delays and possibly your application being refused.

Applying for a Student Guardian visa

If you wish to apply to enter or remain in Australia as a student guardian, complete this form in ENGLISH using BLOCK LETTERS. In order to complete this form you should first read these notes and information form 1234i Applying for a student guardian visa, available from your nearest Australian Government office overseas or the departments website www.immi.gov.au/students/ To help you lodge your application and communicate with the department while your application is being processed you should read information form 1025i Making and processing visa applications, which is available from the departments website www.immi.gov.au/allforms/ Every applicant for a Student Guardian visa must satisfy the criteria for grant. These criteria include, but are not limited to, your relationship to the nominating student, your age, financial capacity, family composition and arrangements for any dependant family members, intention to comply with visa conditions and other relevant matters. Information on these criteria and the conditions, which are likely to be attached to your visa, can be found in the information form 1234i Applying for a student guardian visa, or on the departments website. Your application may be decided solely on the basis of information provided in this application. Failure to answer a question may result in your application being refused if the decision maker cannot be satisfied that you meet all of the criteria for grant of the visa. The provision of information to the department, which is incorrect, may result in cancellation of your visa if it is granted. If you need more space to answer any question, write the details on a separate sheet, sign it and attach it to the application form. You must provide all of the documentation necessary to support your application (originals or certified or notarised copies) and you must declare that you have done so. Failure to do so may result in your application being refused. A decision on your application will be made on the basis of all the information you provide, your circumstances and the legal requirements which apply. If your circumstances change in any way after you make your application you must inform the department of the new circumstances. Failure to do so can lead to cancellation of your visa if it is granted. Applicants who provide false or misleading information may either have their applications refused, or their visa permitting them to remain in Australia cancelled.

Information on studying in Australia

All Student Guardian visa applicants must make a declaration that they have read the www.studyinaustralia.gov.au website. this contains information on studying and living in Australia. Information can also be obtained from state and territory governments and education providers.

About this form

Important Please read this information carefully before you complete your application. Once you have completed your application we strongly advise that you keep a copy for your records.

Who should use this form?

You should use this form if you are: outside Australia and intend to apply for a Student Guardian visa; or in Australia and intend to apply for a further Student Guardian visa; or a visitor, working holiday-maker or other temporary visa holder intending to extend your stay in Australia to reside with a student as their guardian.

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Applying in Australia
If you: are applying in Australia; and do not already hold a Student Guardian visa; and the student nominating you as their guardian is subject to Assessment Level 2, 3 ,4 or 5 for their visa you must provide exceptional reasons for the grant of your visa in Australia. Information on Assessment Levels is available from the departments website www.immi.gov.au/students/

Members of your family unit

Members of your family unit are your partner and dependent children of you or your partner, who are unmarried, not in a de facto relationship and who have not turned 18 years of age. Members of your family unit may be included in your application if: they are under 6 years of age; and they hold a passport that is subject to Assessment Level 1 or 2 for a Schools Sector (subclass 571) student visa; and compassionate and compelling circumstances are found to exist. Partner means your spouse or de facto partner (including same-sex partners).

Welfare arrangements for students under 18 years of age

The department bears no responsibility for welfare arrangements made on a students behalf. It is the responsibility of the parents or legal custodians of a student under the age of 18 to ensure that the arrangements they make on the students behalf provide appropriate welfare for the entirety of the students stay in Australia while they are under the age of 18. If welfare arrangements break down, the parents or legal custodians must make new welfare arrangements or the student under the age of 18 must depart Australia. It is a visa requirement that appropriate welfare arrangements are maintained while the student is under the age of 18. Form 157N Nomination of a student guardian must be completed and lodged together with this form. Failure to do so will result in your application being invalid.

Visa conditions
If you are issued a Student Guardian visa, some conditions will be attached to the grant of the visa. These are the most common conditions. You: must not engage in work while in Australia; must not engage, for more than 3 months, in any studies or training; must maintain your approved Overseas Visitor Health Cover while in Australia; will be subject to a no further stay condition. This means that after entering Australia, you may not be granted any other visa while you remain in Australia, other than a further Student Guardian visa, or a Protection visa; must continue to be a person who would satisfy the primary criteria for the grant of the Student Guardian visa; must reside in Australia, staying with the nominating student to whom your visa relates. You must also provide appropriate accommodation, general welfare and other support arrangements for the nominating student; must not depart Australia without the nominating student to whom your visa relates unless you have provided evidence to the department that there are compassionate or compelling circumstances and that you have put in place alternative arrangements until your return for the nominating students accommodation, general welfare and support. Where the nominating student is less than 18 years, the alternative arrangements must be approved by the nominating students education provider. Different conditions are attached to Student Guardian visas granted to children to accompany a parent to Australia. The conditions applying to children are: they must not work in Australia; they must maintain their approved Overseas Visitor Health Cover while in Australia; they must not enter Australia before a specified person (this will usually be the main Student Guardian visa holder); they must continue to be a person who would satisfy the criteria for grant of a Student Guardian visa.

Photographs
Applying outside Australia enclose 4 recent passport sized photographs of yourself and any family members included in this application. Applying in Australia enclose one recent passport sized photograph of yourself and any family members included in this application.

Health requirements
All applicants are required to meet Australias health requirements. You and any family members included in this application, may be required to undergo a chest x-ray and medical examination. Please refer to form 1163i Health requirements for temporary entry to Australia for further details. This form is available at the departments offices or on the website www.immi.gov.au/allforms/ If applying outside Australia you should not undertake your medical or x-ray examinations until advised to do so by the Australian Government office.

Character requirements
All applicants are required to meet Australias character requirements. More information on character requirements and penal clearances is available from the departments website www.immi.gov.au/allforms/

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Visa Application Charge

Your completed application form, together with the correct Visa Application Charge, can be lodged at the nearest Australian Government office if applying outside Australia, or at the nearest office of the department if applying in Australia. If you are applying outside Australia, you should lodge your application at the same time and place as the nominating student. If the nominating student is already in Australia as the holder of a student visa, you should lodge your application at the nearest office of the department. Visa Application Charges may be subject to adjustment on 1 July each year. This may increase the cost of a visa. You can check the Visa Application Charge at the nearest office of the department, or see form 990i Charges, available from the departments website www.immi.gov.au/allforms/ Payment must accompany your application and is generally not refunded if the application is unsuccessful or if, after lodgement you later decide to withdraw your application.

Migration agent information

A migration agent is someone who can: advise you on the visa that may best suit you; tell you the documents you need to submit with your application; help you fill in the application and submit it; and communicate with the department on your behalf. If you appoint a migration agent, the department will assume that your migration agent will be your authorised recipient, unless you indicate otherwise. Your migration agent will be the person with whom the department will discuss your application and from whom it will seek further information when required. You are not required to use a migration agent. However, if you use a migration agent, the department encourages you to use a registered migration agent. Registered agents are bound by the Migration Agents Code of Conduct, which requires them to act professionally in their clients lawful best interests.

Method of payment
In Australia
To make a payment, please pay by credit card, debit card, bank cheque or money order made payable to the Department of Immigration and Citizenship. Debit card and credit card are the preferred methods of payment.

Immigration assistance
A person gives immigration assistance to you if he or she uses, or claims to use, his or her knowledge or experience in migration procedure to assist you with your visa application, request for ministerial intervention, cancellation review application, sponsorship or nomination. In Australia a person may only lawfully give immigration assistance if he or she is a registered migration agent or is exempt from being registered. Only registered migration agents may receive a fee or reward for providing immigration assistance. If an unregistered person in Australia, who is not exempt from registration, gives you immigration assistance they are committing a criminal offence and may be prosecuted.

Outside Australia
Before making a payment outside Australia, please check with the Australian Government office where you intend to lodge your application as to what methods of payment and currencies they can accept and to whom the payment should be made payable.

Options for receiving written communications

You may authorise another person to receive all communications, both written and electronic, about your application with the department. You will be taken to have received any documents sent to that person as if they had been sent to you. To do this you will need to complete Question 48 Options for receiving written communications and form 956 Appointment of a migration agent or exempt agent or other authorised recipient. For an explanation of what a migration agent or exempt agent or authorised recipient can do please read the sections below. To change or end the appointment of your migration agent or exempt agent or authorised recipient you must promptly advise the department in writing. You can do this by using form 956 Appointment of a migration agent or exempt agent or other authorised recipient.

Migration agents in Australia

Migration agents in Australia must be registered with the Office of the Migration Agents Registration Authority (Office of the MARA) unless they are exempt from registration.

Migration agents outside Australia

Migration agents who operate outside Australia do not have to be registered. The department may give some overseas agents an ID number. This number does not mean that they are registered. Note: Some Australian registered migration agents operate overseas.

Exempt agents
The following people do not have to be a registered migration agent in order to provide immigration assistance, but they must not charge a fee for their service: a close family member (spouse, de facto partner, child, parent, brother or sister); a sponsor or nominator for this visa application; a member of parliament or their staff; an official whose duties include providing immigration assistance (eg. a Legal Aid provider); a member of a diplomatic mission, consular post or international organisation.

Authorised recipient information

An authorised recipient is someone you appoint to receive written communications about your application with the department. All written communication about your application will be sent to your authorised recipient, unless you indicate that you wish to have health and/or character information sent directly to you. The department will communicate with the most recently appointed authorised recipient as you may only appoint one authorised recipient at any time for a particular application.

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Further information on migration agents

Information on migration agents, including a list of registered migration agents, is available on the Office of the MARA website www.mara.gov.au You can also access information about migration agents on the departments website www.immi.gov.au

detention in the event that you become an unlawful non-citizen. You will become an unlawful non-citizen if your visa ceases (for example, by cancellation for breach of visa condition) or expires and you do not hold another visa authorising you to remain in Australia. The collection, access, storage, use and disclosure by the department of the information you provide in this form is governed by the Privacy Act 1988 and, in particular, by the 11 Information Privacy Principles. The information form 993i Safeguarding your personal information gives details of agencies to which your personal information might be disclosed. Form 993i is available from the departments website www.immi.gov.au/allforms/, from any office of the department or Australian mission overseas. The department is authorised under the Migration Act 1958, in certain circumstances, to collect a range of personal identifiers including a facial image, fingerprints and a signature from noncitizens, including from visa applicants. The department requires personal identifiers to assist in assessing your identity. The department is authorised to disclose your personal identifiers and information relating to your name and other relevant biographical data to a number of agencies including law enforcement and health agencies and to other agencies who may need to check your identity with this department. Where the department obtains personal identifiers they will become part of your official record with the department. The department is involved in international information exchanges with a number of countries, including the United Kingdom, the United States of America, Canada and New Zealand. These international information exchanges may involve the sharing of personal identifiers, including facial images and fingerprint data, collected by immigration agencies such as this department. If, as a result of this sharing between countries, there is a match with your personal identifiers, the department will disclose your biographical data, copies of travel and other identity documents or information from such documents, your immigration status and immigration history (which may include any immigration abuse and offences) and any criminal history information relevant to immigration purposes. The purpose of such disclosure would be to help confirm your identity and determine if you have presented to the department and the other agency under the same identity and with similar claims. For more detailed information you should read information form 1243i Your personal identifying information, which is available from the departments website www.immi.gov.au/allforms/ or from any office of the department or Australian mission overseas.

Residential address
You must tell the department where you intend to live while your application is being dealt with. Failure to give a residential address will result in your application being invalid. A post office box address will not be accepted as your residential address.

Consent to communicate electronically

The department may use a range of means to communicate with you. However, electronic means such as fax or e-mail will only be used if you indicate your agreement to receiving communication in this way. To process your application the department may need to communicate with you about sensitive information, for example, health, police checks, financial viability and personal relationships. Electronic communications, unless adequately encrypted, are not secure and may be viewed by others or interfered with. If you agree to the department communicating with you by electronic means, the details you provide will only be used by the department for the purpose for which you have provided them, unless there is a legal obligation or necessity to use them for another purpose, or you have consented to use for another purpose. They will not be added to any mailing list. The Australian Government accepts no responsibility for the security or integrity of any information sent to the department over the internet or by other electronic means.

About the information you give

The department is authorised to collect information provided on this form under Part 2 of the Migration Act 1958. The information collected will be used for assessing your eligibility for a Student Guardian visa to travel to, enter and remain in Australia and for other purposes relating to the administration of the Migration Act, for example to assist migrants with settling in Australia, to monitor the conduct of migration agents, or for ensuring compliance with the Migration Act. The information collected might also be disclosed to agencies who are authorised to receive information relating to adoption, border control, business skills, citizenship, education, health assessment, health insurance, health services, law enforcement, payment of pensions and benefits, taxation, superannuation, review of decisions and registration of migration agents. It will also be disclosed to any agency of the Australian Government, or of a state or territory, that is responsible for or otherwise concerned with the regulation of education providers. Relevant information about you will be disclosed to federal, state and territory police to assist in your location and possible

Review rights
If you apply for a Student Guardian 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 Guardian visa where the application is made outside Australia.

Home page www.immi.gov.au General Telephone 131 881 during business hours enquiry line in Australia to speak to an operator (recorded
information available outside these hours). If you are outside Australia, please contact your nearest Australian mission.

Please keep these information pages for your reference

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Application for a Student Guardian visa

Form

157G

Please use a pen, and write neatly in English using BLOCK LETTERS. Tick where applicable

10 Your present country of citizenship

1 2

How many people are included in this application? Are you applying: for yourself as a Student Guardian? for yourself and family? as a member of the family of a Student Guardian visa holder?

11 Do you hold any other citizenship?

No Yes Which countries?

12 Details from your passport

Passport number Country of passport

Your personal details

Date of issue

DAY

MONTH

YEAR

Your full name in English Family name Given names

Date of expiry Issuing authority/ Place of issue as shown in your passport

Name in your own language or script (if applicable)

13 Details of identity card or identity number issued to you by your

government (if applicable) eg. National identity card. Note: If you are the holder of multiple identity numbers because you are a citizen of more than one country, you need to enter the identity number on the card from the country that you live in. Identity number Country of issue

Have you been known by any other names? (including name at birth, previous married names, aliases) No Yes Give details and provide supporting evidence eg. birth certificate/marriage certificate

14 Your country of usual residence

Family name Given names

15 Your residential address in your home country 6 7 8

Sex Male
DAY

Female
MONTH YEAR

Note: A post office box address is not acceptable as a residential address. Failure to give a residential address will result in your application being invalid.

Date of birth
POSTCODE

Place of birth Town/city Country

16 Your telephone numbers in your home country

COUNTRY CODE AREA CODE ) ( ) ( ) ) NUMBER

Office hours After hours

( (

Relationship status Married Engaged De facto Separated Divorced Widowed

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Never married or been in a de facto relationship

17 Your residential address in Australia (if known)

About your family

A member of your family unit may be granted a Student Guardian visa if: they are under 6 years of age; and

POSTCODE

they hold a passport that is subject to Assessment Level 1 or 2 for a Schools Sector (subclass 571) student visa; and compassionate and compelling circumstances are found to exist. You must give details of all members of your family unit in this application. You must provide evidence of welfare arrangements for any family members under 18 years of age who are not in Australia on a student visa.

18 Your telephone numbers in Australia (if known)

Office hours After hours
(AREA CODE (AREA CODE ) )

19 Address for correspondence 21 Give details of all members of your family unit. This includes family
members in Australia and family members remaining in your home country.
POSTCODE

Members of your family unit are your partner and any dependent children of you or your partner, who are unmarried, not in a de facto relationship and who have not yet turned 18 years of age.
1. Family name Given names

20 Do you agree to the department communicating with you by fax, e-mail

or other electronic means? No Yes Fax number E-mail address Note: If this visa application is refused, you will be notified by mail Date of birth Does this person hold a student visa to study in Australia? Is this person included in this application? No Yes Details from passport Passport number Country of passport No Yes Give details
COUNTRY CODE ( ) ( AREA CODE ) NUMBER

Relationship to you Citizenship(s)

DAY MONTH YEAR

DAY

MONTH

YEAR

Date of issue Date of expiry Issuing authority/Place of issue as shown in passport

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2. Family name Given names Relationship to you Citizenship(s)

DAY MONTH YEAR

22 Are there compassionate and compelling reasons for granting a member

of your family unit under 6 years of age a Student Guardian visa? Not applicable No Yes Give details

Date of birth Does this person hold a student visa to study in Australia? Is this person included in this application? No Yes Details from passport Passport number Country of passport No Yes

DAY

MONTH

YEAR

Date of issue Date of expiry Issuing authority/Place of issue as shown in passport

3. Family name Given names Relationship to you Citizenship(s)

DAY MONTH YEAR

Date of birth Does this person hold a student visa to study in Australia? Is this person included in this application? No Yes Details from passport Passport number Country of passport No Yes

DAY

MONTH

YEAR

Date of issue Date of expiry Issuing authority/Place of issue as shown in passport

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Dependants under 18 years of age

23 Do you have the sole legal right to determine where any dependants
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 Yes Give details below Go to Question 24

Previous visa applications

Warning: In general, a person can only hold one visa at a time. If you are granted a visa while you already have another, the first visa will cease automatically when the new visa is granted.

25 Have you or any other family member

included in this application previously applied for any type of Australian visa? Do you currently hold an Australian visa? Are you currently awaiting a decision on another Australian visa application? If you answered Yes to any of the above questions, give details below 1. Type of visa No No Yes Yes

Give details of all other people who have 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.
1. Family name Given names

No

Yes

Residential address

Place of issue
DAY MONTH YEAR

Date of issue
POSTCODE

Application Telephone number Relationship to dependant Nature of legal right Statutory declaration attached? 2. Family name Given names No Yes
COUNTRY CODE ( ) ( AREA CODE ) NUMBER

Refused Granted V < Visa label number

If granted a visa without a label, provide the 13-digit visa grant number (as shown on the letter notifying you of visa grant).

2. Type of visa Place of issue

DAY MONTH YEAR

Residential address

Date of issue Application Refused Granted

POSTCODE COUNTRY CODE ( ) ( AREA CODE ) NUMBER

Visa label number <

Telephone number Relationship to dependant Nature of legal right

If granted a visa without a label, provide the 13-digit visa grant number (as shown on the letter notifying you of visa grant).

Statutory declaration attached?

No

Yes

24 Are any of your dependants 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 Yes Attach a certified copy of the court order(s)

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Nominating student details

Provide details of the student who has nominated you on form 157N Nomination of student guardian as their guardian.

32 Has the nominating student applied for a student visa to study

in Australia? No Yes Provide details below
DAY MONTH YEAR

26 Students full name in English

Family name Given names

Date of application Office where application was lodged

27 What is your relationship to the nominating student? (tick one box only)
Spouse De facto partner Parent Sibling Grandparent
DAY MONTH YEAR

Legal custodian Aunt or uncle Niece or nephew Step-parent

Step-sibling Step-grandparent Step-aunt or uncle Step-niece or nephew

28 Students date
of birth

29 Details from students passport

Passport number Country of passport
DAY MONTH YEAR

Date of issue Date of expiry Issuing authority/ Place of issue as shown in passport

30 Has the nominating student completed form 157N Nomination of a

student guardian to nominate you as their guardian?
No You must lodge form 157N, completed by your nominating student, with this application. Failure to do so will result in your application being invalid. Please lodge the completed form 157N with this application.

Yes

31 Has the nominating student been granted a student visa to study

in Australia? No Yes Provide details below

Visa label number (if known) V or Visa grant number (as shown on the letter notifying you of visa grant) Now go to Question 33 <

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Financial details
33 Do you have access to sufficient funds to support yourself and any family
members included in this application for the TOTAL period of your stay in Australia (including living costs and travel costs)? Living costs are a minimum amount set for visa purposes. Living costs vary depending on where you will be living. It is your responsibility to determine what your own costs will be to live in Australia. No Yes Please complete the declaration below

Health to be completed by all applicants

36 In the last 5 years, have you, or any other person included in this
application, visited, or lived, outside your country of passport for more than 3 consecutive months? No Yes 1. Name Country(s)
DAY MONTH YEAR DAY MONTH YEAR

Give details

I declare that I have access to sufficient funds to support myself for the total period of my stay in Australia.
Your signature

Date from 2. Name Country(s)

DAY MONTH YEAR

to

DAY

MONTH

YEAR

DAY

MONTH

YEAR

Date from 3. Name Country(s)

DAY MONTH YEAR

to

Date

You must provide evidence of your financial capacity to support your stay in Australia. The amount, type and source of funds considered acceptable, and the savings period for funds will vary with the Assessment Level of the student who has nominated you as their guardian. Further information is available from your nearest Australian Government office or the departments website. Information on Assessment Levels can be found on the departments website www.immi.gov.au/students/

DAY

MONTH

YEAR

Date from

to

37 Do you, or any other person included in this application, intend to enter

a hospital or a health care facility (including nursing homes) while in Australia? No Yes Give details

Applying in Australia
34 Are you applying in Australia?
No Yes

35 Do you currently hold a Student Guardian visa?

No Yes Give details below Go to Question 36

38 Do you, or any other person included in this application, intend to work

as, or study to be, a doctor, dentist, nurse or paramedic during your stay in Australia? No Yes Give details

If the student nominating you is subject to Assessment Level 2, 3, 4, or 5, you are required to provide exceptional reasons why you should be granted a Student Guardian visa in Australia.

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39 Have you, or any other person included in this application:

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? No Yes Give details

41 Do you, or any other person included in this application, require assistance

with mobility or care due to a medical condition? No Yes Give details

40 During your proposed visit to Australia, do you, or any other person

included in this application, 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? No Yes Give details

You are strongly advised to carry certification of your vaccination status, especially for children attending Australian child care centres (including preschools and creches) and schools. Vaccination against polio, tetanus, measles, mumps, rubella, diphtheria, pertussis (whooping cough), Haemophilus influenzae hypo B (Hib), and Hepatitis B is recommended for children, with certification sought at time of child care centre (including preschool and creche) and school enrolment. Vaccination against rubella is also recommended for women of child bearing age.

42 Have you and each member of your family unit included in this application
paid the Overseas Visitor Health Cover (OVHC)? No Yes Please provide evidence

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Character
43 Have you ever:
been convicted of a crime or offence in any country (including any conviction which is now removed from official records)? been charged with any offence that is currently awaiting legal action? been acquitted of any criminal offence or other offence on the grounds of mental illness, insanity or unsoundness of mind? been removed or deported from any country (including Australia)? left any country to avoid being removed or deported? been excluded from or asked to leave any country (including Australia)? committed, or been involved in the commission of war crimes or crimes against humanity or human rights? been involved in any activities that would represent a risk to Australian national security? had any outstanding debts to the Australian Government or any public authority in Australia? been involved in any activity, or been convicted of any offence, relating to the illegal movement of people to any country (including Australia)? served in a military force or state sponsored/private militia, undergone any military/paramilitary training, or been trained in weapons/explosives use (however described)?

Assistance with this form

44 Did you receive assistance in completing this form?
No No No Yes Yes Yes Title: Mr Go to Question 48 Please give details of the person who assisted you Mrs Miss Ms Other

Family name Given names

No No No No

Yes Yes Yes

Address

POSTCODE

Telephone number or daytime contact Yes Office hours No Yes Mobile/cell

( COUNTRY CODE ) ( AREA CODE ) NUMBER

45 Is the person an agent registered with the Office of the Migration Agents
No Yes Registration Authority (Office of the MARA)? No Yes No Yes Go to Question 48

46 Is the person/agent in Australia?

No No Yes Yes Go to Question 48

47 Did you pay the person/agent and/or give a gift for this assistance?
No Yes No Yes

If you answered Yes to any of the above questions, you must give ALL relevant details below. 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.

Options for receiving written communications

48 All written communications about this application should be sent to:
(Tick one box only)
Myself OR Authorised recipient OR Migration agent OR Agent exempt from registration All written communications will be sent to the address for communications that you have provided in this form. You must complete form 956 Appointment of a migration agent or exempt agent or other authorised recipient and attach it to this application form. Form 956 is available from the departments website www.immi.gov.au

If insufficient space, attach an additional statement.

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Payment details
49 How will you pay your application charge?
If applying in Australia, debit card or credit card are the preferred methods of payment. Debit cards cannot be used for applications lodged by mail. If paying by bank cheque or money order please make payable to the Department of Immigration and Citizenship. If applying outside Australia, please check with the Australian Government office where you intend to lodge your application as to what methods of payment and currencies they can accept and to whom the payment should be made payable. Bank cheque Money order Debit card Credit card Cannot be used for applications lodged by mail Give details below Australian Dollars Diners Club JCB AUD

Payment by (tick one box) MasterCard American Express Visa Credit card number : : : : :
MONTH

: :

:
YEAR

Expiry date Cardholders name

COUNTRY CODE

AREA CODE ) ( )

NUMBER

Telephone number Address

POSTCODE

Signature of cardholder Credit card information will be used for charge paying purposes only.

Further information
If there is any other information or documentation you would like taken into consideration in assessing your application, attach it to the application. Remember that a decision may be based solely on the information you provide in this application.

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Declaration and consent

WARNING: Giving false or misleading information is a serious offence.

The following declaration and consent must be signed and dated by all people over 18 years included in this application. Both parents or any person who has legal custody must complete the declaration on behalf of any children under 18 years of age.

50 I declare that:
the information supplied on or with this form is correct. I have attached all documentary evidence as required. I will reside with and provide appropriate care and welfare arrangements for the nominating student. I declare that I have made adequate arrangements for health insurance 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 Guardian visa. If granted a visa, I acknowledge that I am required to abide by its conditions as outlined in the information form 1234i Applying for a Student Guardian visa. I understand that the 8537 condition will be imposed on my visa. I acknowledge that this means I must: reside in Australia while the nominating student, for whom my visa relates, is in Australia; while in Australia, stay with the nominating student; and provide appropriate accommodation, general welfare and support arrangements for the nominating student. I understand that the 8538 condition will be imposed on my visa. I acknowledge that this means I must not depart Australia without the nominating student to whom my visa relates unless I have given the department evidence that: there are compassionate or compelling circumstances for my departure; alternative arrangements have been put in place until my return for the nominating students accommodation, general welfare and other support arrangements; and where the nominating student is less than 18 years, the alternative arrangements have been approved by the nominating students education provider. I understand that the 8534 visa condition will be imposed on my visa, and will be indicated by the condition code 8534 and by the short description No Further Stay. I acknowledge that this means that I will not, while in Australia, be entitled to the grant of any other visa1, apart from a further Student Guardian visa. I understand that the effect of the 8534 visa condition is that, apart from a further Student Guardian visa, it will not be possible for me to apply to remain in Australia beyond the date authorised by my visa1, and that I will be required to depart Australia on or before that date. I am aware that I must immediately advise the department if I become aware that any information provided in this form is incorrect or if there is a change in my circumstances that are relevant to this application at any time. I will respect Australian values as listed on this form, during my stay in Australia and will obey the laws of Australia. I declare that I have read the information contained in the www.studyinaustralia.gov.au website on living and studying in Australia including information on the cost of living, accommodation and employment.
For offshore applicants who are required to provide their fingerprints and facial image:

I understand that my fingerprints and facial image and my biographical information held by the Department of Immigration and Citizenship may be given to Australian law enforcement agencies to help identify me, to help determine my eligibility for grant of the visa I have applied for, and for law enforcement purposes. I consent to: Australian law enforcement agencies disclosing my biometric, biographical and criminal record information to the Department of Immigration and Citizenship for any of the purposes outlined above; and the Department of Immigration and Citizenship using the information obtained for the purposes of the Migration Act 1958 or the Citizenship Act 2007.

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We strongly advise that you keep a copy of your application and all attachments for your records.

1 Except in extremely limited circumstances that are outside your control, or to engage Australias protection obligation under the 1951 UN convention relating to the status of refugees.

157G (Design date 11/10) - Page 14

COMMONWEALTH OF AUSTRALIA, 2010