Student Visa Subclass 500 Application Checklist

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1 Current Visa Type Expiry Date: DIBP: Lodgment date: Page 1 of 23 Student Visa Subclass 500 Application Checklist 1. Current location Give details of your current location. Current location 2. Application type Is this the first time the applicant is applying for a student visa? If you currently hold a student visa, please enter the details below: Student visa number: Student visa expiry date: 3. Confirmation of enrolment List any current COEs you have from another provider (if you have any COE not from Envirotech): Is this course a continuation of the applicant's studies or training outside Australia? Is any of the courses (Envirotech or other Education provider) is a continuation of studies from overseas? 4. Other evidence of intended study Does the applicant hold evidence of their intended study in Australia other than a CoE? If yes, please specify: 5. Education Section Select the education sector for the courses you are applying for: 6. VET ELICOS Commonwealth funded student Did you receive partial or full funding under a training scheme approved by the Commo nwealth government of Australia, give details below:

2 Page 2 of Primary applicant Information: Entering names incorrectly may result in denial of permission to board an aircraft to Australia, or result in delays in border processing on arrival in Australia, even if the applicant has been granted a visa Passport details Enter the following details as they appear in the applicant's passport. Family name Given names Sex Male Female Other Date of birth (dd/mm/yyyy) Passport number Country of passport Nationality of passport holder Date of issue (dd/mm/yyyy) Date of expiry (dd/mm/yyyy) Place of issue / issuing authority It is strongly recommended that the passport be valid for at least six months Place of birth Town / City State / Province Country of birth 7.3. Relationship status Relationship status

3 Page 3 of Other names / spellings List all other names that you currently, or ever been known by: First Name Family Name Reasons for Change 7.5. Citizenship Is this applicant a citizen of the country of passport? List any other country the primary applicant is a citizen of: 7.6. Other passports Does this applicant have other current passports? If yes, enter the following details as they appear in the applicant's passport. Family name Given names Sex Male Female Other Date of birth (dd/mm/yyyy) Passport number Country of passport Nationality of passport holder Date of issue (dd/mm/yyyy) Date of expiry (dd/mm/yyyy) Place of issue / issuing authority 7.7. National identity documents List any national identity documents held by the primary applicant Please provide details of any of the following: Alien registration number, Birth certificate, Drivers licence, Marriage certificate, National Identity document, or Social security card Type of document Document number Country of document 7.8. Health examination Has this applicant undertaken a health examination for an Australian visa in the last 12 months? If yes, please provide details below: Medical exam date Name Location For what visa

4 Page 4 of Accompanying family members any family members included in this application, if applicable: Dependent Applicant 1 Relationship to applicant and family status Relationship to applicant (Child, partner) Family Status Never married, Married, divorced, De facto, Widow Passport Details Family Name Given Name Sex Date of birth (dd/mm/yyyy) Passport Number Country of Passport Nationality of passport holder Date of issue (dd/mm/yyyy) Date of expiry (dd/mm/yyyy) Place of issue / issuing authority Is this family member a citizen of the country of passport? Place of birth: Town / City State / Province Country of birth Other names / spelling of your name Full Name Reason for change Citizenship in any other countries Country From date (dd/mm/yyyy) Other Passports Country of passport Name on passport Issue Date Expiry Date Issuing authority National Identity documents Type of document Document number Country Health Examination, for an Australian visa in the last 12 months? Medical exam date Name of Medical centre Location For what visa Child custody details Is the family member a child under 18 years of age? If yes, is this child in the primary applicant s care and legal custody? Does any other person have custodial access or guardianship rights to the child? If yes, give details: Are there any legal impediments to the child s travel? If yes, give details: / no / no / no / no

5 Page 5 of 23 Dependent Applicant 2 Relationship to applicant and family status Relationship to applicant (Child, partner) Family Status Never married, Married, divorced, De facto, Widow Passport Details Family Name Given Name Sex Date of birth (dd/mm/yyyy) Passport Number Country of Passport Nationality of passport holder Date of issue (dd/mm/yyyy) Date of expiry (dd/mm/yyyy) Place of issue / issuing authority Is this family member a citizen of the country of passport? Place of birth: Town / City State / Province Country of birth Other names / spelling of your name Full Name Reason for change Citizenship in any other countries Country From date (dd/mm/yyyy) Other Passports Country of passport Name on passport Issue Date Expiry Date Issuing authority National Identity documents Type of document Document number Country Health Examination, for an Australian visa in the last 12 months? Medical exam date Name of Medical centre Location For what visa Child custody details Is the family member a child under 18 years of age? If yes, is this child in the primary applicant s care and legal custody? Does any other person have custodial access or guardianship rights to the child? If yes, give details: Are there any legal impediments to the child s travel? If yes, give details: / no / no / no / no

6 Page 6 of 23 Dependent Applicant 3 Relationship to applicant and family status Relationship to applicant (Child, partner) Family Status Never married, Married, divorced, De facto, Widow Passport Details Family Name Given Name Sex Date of birth (dd/mm/yyyy) Passport Number Country of Passport Nationality of passport holder Date of issue (dd/mm/yyyy) Date of expiry (dd/mm/yyyy) Place of issue / issuing authority Is this family member a citizen of the country of passport? Place of birth: Town / City State / Province Country of birth Other names / spelling of your name Full Name Reason for change Citizenship in any other countries Country From date (dd/mm/yyyy) Other Passports Country of passport Name on passport Issue Date Expiry Date Issuing authority National Identity documents Type of document Document number Country Health Examination, for an Australian visa in the last 12 months? Medical exam date Name of Medical centre Location For what visa Child custody details Is the family member a child under 18 years of age? If yes, is this child in the primary applicant s care and legal custody? Does any other person have custodial access or guardianship rights to the child? If yes, give details: Are there any legal impediments to the child s travel? If yes, give details: / no / no / no / no

7 Page 7 of 23 Contact details 9. Department office You may be required to attend an Australian Government Office for an interview. Which is the closest office to the applicant s current location? The nearest DIBP Office is 10. Country of residence (For student visa this should be the applicant s home country) Usual country of residence 11. Residential address in usual country of residence te that a street address is required. A post office address cannot be accepted as a residential address. Country Address Suburb / Town State or Province Postal code 12. Contact telephone numbers in usual country of residence Business phone Home phone Mobile / Cell phone 13. Residential address in Australia Give details of your residential address in Australia (if known). te that a street address is required. A post office address cannot be accepted as a residential address. Country AUSTRALIA Address Suburb / Town State or Province Postal code

8 Page 8 of Contact telephone numbers in Australia Business phone Home phone Mobile / Cell phone 15. Postal address for correspondence Postal address for correspondence Country Address Suburb / Town State or Province Postal code 16. address address 17. Authorised recipient Provide details of any person you wish to authorised to receive written correspondence on the student behalf This person will be referred to as the 'authorised recipient'. MARN/Education agent number (if applicable) Family name Given name Organisation Postal Address Contact telephone number/s address 18. Other family members List all your other family members (not partners or children), e.g.: parents or siblings both in and outside of Australia Relationship to the primary applicant Family name Given name Sex Date of birth Usual country of residence Material status

9 Page 9 of n accompanying family members If you have any family members (partner or children) not already included as an 'Accompanying family member' in this application, then Provide details of these non accompanying family members: Please note that if these non-accompanying family unit member's details are not included in this application, they will not be eligible for grant of a student visa at a later date. Dependent Applicant 1 Relationship to applicant and family status Relationship to applicant (Child, partner) Family Status Never married, Married, divorced, De facto, Widow Personal Details Family Name Given Name Sex Date of birth (dd/mm/yyyy) Place of birth: Town / City State / Province Country of birth Other names / spelling of your name Full Name Reason for change Citizenship in any other countries Country From date (dd/mm/yyyy) Passports Country of passport Name on passport Issue Date Expiry Date Issuing authority National Identity documents Type of document Document number Country Health Examination, for an Australian visa in the last 12 months? Medical exam date Name of Medical centre Location For what visa Child custody details Is the family member a child under 18 years of age? If yes, is this child in the primary applicant s care and legal custody? Does any other person have custodial access or guardianship rights to the child? If yes, give details: Are there any legal impediments to the child s travel? If yes, give details: / no / no / no / no

10 Page 10 of Genuine temporary entrant All student visa applicants are required to provide information in support of their application to demonstrate that they meet the Genuine Temporary Entrant criteria. I declare that I have satisfied the following criteria: Reasons for choosing to undertake the specified courses are provided Reasons for choosing Envirotech as education provider are provided Reasons for choosing to study in Australia rather than in a home country/usual country of residence were given Financial capacity requirements are met and documentary evidence is provided Genuine access to funds demonstrated to meet the first year of study and living expenses: Student AUD Partner/Spouse AUD 6940 Child AUD 2970 Return Ticket Tuition Fees Student meet the English language requirements for the entry to the chosen course fulfilled Relevance of courses to student academic/employment background have been demonstrated Relevance of courses to the student future career/educational plans The student can demonstrate a genuine intention to stay in Australia temporarily The student demonstrated circumstances in home country, potential circumstances in Australia, value of the course to the future that satisfies intention to be a Genuine Student If the student had previously traveled to Australia, the reason for that travel and the duration of stay is provided Student demonstrates knowledge in their course content and the individual units in the course IMPORTANT Give details to support the ability to meet the criteria and demonstrate each of the areas listed above. Ensure supporting documents are attached to support a positive student visa outcome. You will have to provide this information to the Department of Immigration and Border Protection (DIBP) during your student visa application. Please record your statement of meeting the GTE criteria below:

11 Page 11 of Funding for stay Do all applicants in this application confirm that they each have access to sufficient funds to support themselves for the total period of stay in Australia and understand that further evidence of funds may also be requested? Show how each applicant included in the application will support themselves in Australia to meet living, tuition and school costs. Select any that apply. Funding type: Government scholarship / financial support Other organisation scholarship / financial support Financial support from an individual Other financial support - if you will support yourself, please provide details in Q Financial support from an individual or applicant's own funds Please check financial requirements here or in Q.20 of this cheklist Will the funds be provided by an individual other than the applicant? Please provide details of your sponsor or your own financial capacity: Supporting person Full name Relationship to the applicant Approximate value in Australian Dollars (AUD) Funding type Financial Institution 23. Overseas Student Health Cover Did you request Envirotech to arrange your Overseas Student Health Cover (OSHC)? If not, provide the following OSHC details: Name of health insurer Insurance policy number Date from (dd/mm/yyyy) Date to (dd/mm/yyyy)

12 Page 12 of Education give details of all your current and past education history, starting from high school Qualification level Course Name Full Name of Institution (no abbreviations) Status (Enrolled, Completed, not completed, withdrawn) Campus/address of Institution Country Date From (dd/mm/yyyy) Date to (dd/mm/yyyy)

13 Page 13 of Employment give details of ALL your employment and unemployment history since leaving high school until today Employer / Business Details Organisation Address Contact Person Full address of business/company Country Full Name Business Phone Organisation Full Name Industry Type (e.g. Health Care, Hospitality, etc.) (Building number, street name, suburb, town/city, state/province) (no Post Office box) Mobile Position (occupation) Status (Employed, Self Employed, Unemployed, Retired) Date "From" dd/mm/yy Date "To" dd/mm/yy

14 Page 14 of Future employment Are you offered a job at the completion of your course? If YES, please provide details of the employer / business: Organisation name Industry type Organisation street address (A post office address cannot be accepted): Country Address Suburb / Town State or Province Postal code Contact person details Give details of the contact person within the organisation. Family name Given names Business phone Mobile / Cell phone Position details Position If NO, please provide details of the type of employment, you will be seeking at the completion of your course

15 Page 15 of Language ability Primary Applicant Language Ability English Test Did you undertake an English language test within the last 24 months? If YES give details of the English test highest scoring English test over the 24 month period. Name of test Date of test Test reference number Country where test was undertaken Overall test score Main language Your main language Study in English language Did you successfully complete at least five years study (in the English language) in Australia, Canada, New Zealand, Republic of South Africa, Republic of Ireland, United Kingdom and/or United States of America? In the two years before applying for the Student visa, has the applicant successfully completed the requirements for a Senior Secondary Certificate of Education (conducted in English in Australia)? In the two years before applying for the Student visa, has the applicant successfully completed a substantial component of a course leading to a qualification from the Australian Qualifications Framework at Certificate IV or higher as a holder of a Student visa (conducted in English in Australia)? 28. Language ability Dependent Applicants Dependent Applicant 1 main language Dependent Applicant 2 main language Dependent Applicant 3 main language Dependent Applicant 4 main language

16 Page 16 of Countries visited Have any of the applicants visited any countries in the past 10 years? Include: Work or study outside your usual country of residence Holiday/leisure trips Business Military deployment Visits back to your usual country of residence if living away Applicant name Country Date from Date to Visa Type Reason for visit 30. Australian Visa history Has the applicant, or any person included in this application, held or currently hold a visa to Australia or any other country? IIf yes, please provide details below: Applicant name Australian Visa Type Grant Number Grant Date Expiry Date Entered Australia with this visa (yes/no)

17 Page 17 of Visa Declaration Has the applicant, or any person included in this application, ever been in Australia or any other country and not complied with visa conditions or departed outside their authorised period of stay? Has the applicant, or any person included in this application, ever had an application for entry or further stay in Australia or any other country refused, or had a visa cancelled? If yes, please provide details: 32. Health declarations In the last five years, has any applicant visited, or lived, outside their country of passport, for more than 3 consecutive months? Do not include time spent in Australia. If yes, please provide details: Applicant name Country From Date To Date Country

18 Page 18 of 23 Does any applicant intend to enter a hospital or a health care facility (including nursing homes) while in Australia? Does any applicant intend to work as, or study to be a doctor, dentist, nurse or paramedic during their stay in Australia? Does any applicant intend to work or be a trainee at a child care centre (including preschools and crèches) while in Australia? Has any applicant: 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? During their proposed visit to Australia, does any applicant 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? Does any applicant require assistance with mobility or care due to a medical condition? If yes, please provide details:

19 Page 19 of Character declarations Has any applicant ever been charged with any offence that is currently awaiting legal action? Has any applicant ever been convicted of an offence in any country (including any conviction which is now removed from official records)? Has any applicant ever been the subject of an arrest warrant or Interpol notice? Has any applicant ever been found guilty of a sexually based offence involving a child (including where no conviction was recorded)? Has any applicant ever been named on a sex offender register? Has any applicant ever been acquitted of any offence on the grounds of unsoundness of mind or insanity? Has any applicant ever been found by a court not fit to plead? Has any applicant ever been directly or indirectly involved in, or associated with, activities which would represent a risk to national security in Australia or any other country? Has any applicant ever been charged with, or indicted for: genocide, war crimes, crimes against humanity, torture, slavery, or any other crime that is otherwise of a serious international concern? Has any applicant ever been associated with a person, group or organisation that has been or is involved in criminal conduct? Has any applicant ever been associated with an organisation engaged in violence or engaged in acts of violence (including war, insurgency, freedom fighting, terrorism, protest) either overseas or in Australia? Has any applicant ever served in a military force, police force, state sponsored / private militia or intelligence agency (including secret police)?

20 Page 20 of 23 Has any applicant ever undergone any military/paramilitary training, been trained in weapons/explosives or in the manufacture of chemical/biological products? Has any applicant ever been involved in people smuggling or people trafficking offences? Has any applicant ever been removed, deported or excluded from any country (including Australia)? as any applicant ever overstayed a visa in any country (including Australia)? Has any applicant ever had any outstanding debts to the Australian Government or any public authority in Australia? Give Details:

21 Page 21 of Student declarations Warning: Giving false or misleading information is a serious offence. The applicants declare that they: Have read and understood the information provided on the website ( regarding living and studying in Australia. Have access to sufficient funds to support themselves for the total period of stay in Australia. They also understand that they may be requested to provide further evidence of funds. Have made adequate arrangements to health insurance for the period of their stay in Australia and acknowledge they are required to maintain these arrangements while in Australia as the holder of a student visa. Understand that a student visa is a temporary visa and that being granted a student visa will not guarantee that they will be eligible for the grant of a further visa to stay in Australia, including a skilled migration visa. Understand that if they cannot obtain a further visa they must depart Australia on or before the cease date of the student visa. Acknowledge that if granted a student visa, they are required to understand and abide by its conditions. Understand that if the 8534 visa condition is imposed on the student visa, it will be indicated by the condition code 8534 and by the short description Further Stay. They acknowledge that this means the 8534 condition has been imposed on their visa and while in Australia they will only be entitled to the grant of limited visas including: A subclass 485 (Temporary Graduate) visa, or A subclass 590 (Student Guardian) visa. Understand that the effect of 8534 visa condition is that it will not be possible to apply to remain in Australia beyond the date authorised on the student visa and that they will be required to depart Australia on or before that date. Understand that if the 8535 visa condition is imposed on the student visa, it will be indicated by the condition code 8535 and by the short description Further Stay. They acknowledge that this means that the 8535 condition has been imposed on their visa and while in Australia they will only be entitled to the grant of limited visas including: A further student visa (subclass 500) in circumstance where the Commonwealth, or foreign government (as the case requires), does not oppose them from obtaining a further visa to stay in Australia. Understand that the effect of the 8535 visa condition is that it will not be possible to remain in Australia beyond the date authorised on the student visa, unless they are applying for a further student visa in circumstances where the Commonwealth or a foreign government (as the case requires) does not oppose them undertaking a relevant course of study, and that they will be required to depart Australia on or before the authorised date.

22 Page 22 of Declarations Warning: Giving false or misleading information is a serious offence. The applicants declare that they: Have read and understood the information provided to them in this application. Have provided complete and correct information in every detail on this form, and on any attachments to it. Understand that if any fraudulent documents or false or misleading information has been provided with this application, or if any of the applicants fail to satisfy the Minister of their identity, the application may be refused and the applicant(s), and any member of their family unit, may become unable to be granted a visa for a specified period of time. Understand that if documents are found to be fraudulent or information to be incorrect after the grant of a visa, the visa may subsequently be cancelled. Understand that if this application is approved, any person not included in this application will not have automatic right of entry to Australia. Will inform the Department of Immigration and Border Protection in writing immediately as they become aware of a change in circumstances (including change of address) or if there is any change relating to information they have provided in or with this application, while it is being considered. Have read the information contained in the Privacy tice (Form 1442i). Understand that the department may collect, use and disclose the applicant's personal information (including biometric information and other sensitive information) as outlined in the Privacy tice (Form 1442i). Give consent to the collection of their fingerprints and facial image. Understand that, if required to provide their fingerprints and facial image, the applicant's fingerprints and facial image and biographical information held by the Department of Immigration and Border Protection may be given to Australian law enforcement agencies to help identify the applicant and determine eligibility for grant of the visa being applied for, and for law enforcement purposes. Give consent to Australian law enforcement agencies disclosing the applicant's biometric, biographical and criminal record information to the Department of Immigration and Border Protection to help identify the applicant, to determine eligibility for grant of a visa and for law enforcement purposes. Give consent to the Department of Immigration and Border Protection using the applicant's biometric, biographical and criminal record information obtained for the purposes of the Migration Act 1958 or the Citizenship Act 2007.

23 Page 23 of Australian values All persons included in this application who are 18 years or over have read, or had explained to them, information provided by the Australian Government on Australian society and values and agrees to the Australian values statement. Link to Border Protection - Short Statement 37. Providing supporting evidence Attaching supporting evidence prior to submitting will assist the department in processing the application. List of required attachments: Passport (Certified Copy) Other Identity document (Birth Certificate, Driver Licence) Academic Qualifications and Transcripts (Certified Copies) Evidence of English Language Proficiency (i.e. IELTS 5.5, TOEFL, PTE) Please check your English requirement through this link: Evidence of Work Experience (CV/Resume, Employment Letter) Evidence of Job Offer in home country (upon completion of studies in Australia) Financial Capacity evidence (Bank Statement, Sponsor Letter of Support, Sponsor ID) Overseas Student Health Cover Insurance Evidence of Genuine Temporary Entrant Requirement Form 956A (Please complete this form if you authorise Envirotech as 'authorised recipient') I declare that all the information provided is true and correct. Applicant Full Name: Applicant Signature: Date:

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