Assessment Form Please complete all sections for quick assessment. Note: Sections tagged red asterisk (*) symbol must be completed before submission. Title Mr Miss Mrs Ms Student's Name First Last Email Phone Number Address Street Address Address 2 City State / Province Postal / Zip Code Country... Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua & Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire Bosnia & Herzegovina Botswana Brazil British Indian Ocean Ter Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Canary Islands Cape Verde Cayman Islands Central African Republic Chad Channel Islands Chile China Christmas Island Cocos Island Colombia Comoros Congo Cook Islands Costa Rica Cote D'Ivoire Croatia Cuba Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Ter Gabon Gambia Georgia Germany Ghana Gibraltar Great Britain Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guyana Haiti Hawaii Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea North Korea South Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malaysia Malawi Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Midway Islands Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Nambia Nauru Nepal Netherland Antilles Netherlands (Holland, Europe) Nevis New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Norway Oman Pakistan Palau Island Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Island Poland Portugal Puerto Rico Qatar Republic of Montenegro Republic of Serbia Reunion Romania Russia Rwanda St Barthelemy St Eustatius St Helena St Kitts-Nevis St Lucia St Maarten St Pierre & Miquelon St Vincent & Grenadines Saipan Samoa Samoa American San Marino Sao Tome & Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Tahiti Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad & Tobago Tunisia Turkey Turkmenistan Turks & Caicos Is Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States of America Uruguay Uzbekistan Vanuatu Vatican City State Venezuela Vietnam Virgin Islands (Brit) Virgin Islands (USA) Wake Island Wallis & Futana Is Yemen Zaire Zambia Zimbabwe Country Date of Birth DD MM YYYY Country of Passport Student's Passport Photo / Biodata Page Student's resume / CV Marital Status Never Married Married / De Facto Separated Divorced Widowed Date of Marriage- if married DD MM YYYY Marriage Certificate / Registration- if married Spouse's Name- if married First Last Spouse's Passport Biodata / Photo Page- if applicable Spouse's Resume/ CV- if applicable Child's Passport Biodata / Photo page How many people will be mentioned in the visa application form: Any previous Australian Visa History or visa refusal of any country. Please provide details if applicable: Upload previous Visa Refusal or cancelled evidence- if applicable Any previous Australian Institute / University admission refusal. Please provide details if applicable: Previous travel or Visa Information of Australia (if applicable) Please upload evidence of previous travel / Visit to Australia- if applicable: Any family members or relatives in Australia. Please provide details: IELTS / PTE Test Date DD MM YYYY IELTS / PTE Overall Score 5.0 / 36 5.5 / 43 6.0 / 50 6.5 / 58 7.0 / 65 7.5 / 72 8.0 / 79 8.5 / 85 9.0 / 90 Preferred Level of Course Master / Post Graduate Bachelor / Under Graduate Diploma / Advanced Diploma High School English Research Preferred Course Name Preferred Location Sydney Melbourne Brisbane Adelaide Perth Darwin Canberra Hobart Preferred University / Institute: Preferred Intake/ Start Date: DD MM YYYY Year 10 Grades / Percentage / Completion Date Upload Year 10 Certificates / Transcripts Year 12 Grades / Percentage Year 12 Certificates / Transcript Bachelor Degree- Grades / Percentage / Backlogs Upload Bachelor Degree Certificates / Transcripts Masters or Post Graduate: Grades / Percentage / Backlogs Upload Master Degree / Post Graduate Certificates / Transcripts Employment Details- if applicable Upload Employment Evidence- if applicable Sponsor/s Parents Grandparents Spouse Siblings Uncle / Aunt Sources of sponsorship funds Education Loan / Loan Savings/ Term Deposit Fixed Deposit Others Total Annual Income of all Sponsor/s Please note: anyone who is providing finances must be an acceptable relative (please check steps and checklist for the student visa that you are applying for). In brief money must be in the bank for 6 months/ Education Loan before you apply for a student visa and it must be consistent with the income of the account holder. Additional Important Information: All above information and uploaded documents need to genuine and authentic on submission. If you're not a fish leave this field blank:
