EZIMMI
Home
All Applications
Part 1
Description of part 1.
Save and Continue
Current Location
I am currently outside Australia
Street No.
Unit No.
Suite No.
Building No.
Street Name
Street Type
Select...
Road
Street
Avenue
Town/City
State/Region
Postal Code
Country
Select Country...
Australia
Canada
New Zealand
United Kingdom
United States
Legal Status
Select...
Status One
Status Two
Status Three
Current Visa Expiry Date
Current Visa Type
Select...
Visa Type One
Visa Type Two
Visa Type Three
Current Location Details
+ Add Item
Visitor Context
Visitor Stream
Select...
Stream 1
Stream 2
Stream 3
Main Purpose of Visit
Visit Reasons
+ Add Item
Significant Dates
+ Add Row
Intended Entries
+ Add Item
Special Category of Entry
Are you travelling as a representative of a foreign government, or travelling on a United Nations Laissez-Passer?
Identity
Given Name(s)
Other Name(s)
Family Name
Title
Select...
Mr.
Mrs.
Miss
Ms.
Dr.
Gender
Select...
Male
Female
Prefer not to say
Date of Birth
City of Birth
Country of Birth
Select Country...
Australia
Canada
New Zealand
United Kingdom
United States
Country of Citizenship
Select Country...
Australia
Canada
New Zealand
United Kingdom
United States
Passport Number
Passport Country
Select Country...
Australia
Canada
New Zealand
United Kingdom
United States
Passport Issue Date
Passport Expiry Date
National Identity Card Number
Contact
Country of Residence
Select Country...
Australia
Canada
New Zealand
United Kingdom
United States
Closest Department Office
Select Closest Department Office...
London Branch
Sydney Central Office
Street No.
Unit No.
Suite No.
Building No.
Street Name
Street Type
Select...
Road
Street
Avenue
Town/City
State/Region
Postal Code
Country
Select Country...
Australia
Canada
New Zealand
United Kingdom
United States
Mobile Phone Number
Email Address
Preferred Contact Method
Select...
Home Phone
Mobile Phone
Work Phone
Email
Postal address is different to contact address
Postal Address Details
Street No.
Unit No.
Suite No.
Building No.
Street Name
Street Type
Select...
Rd
St
Ave
Town/City
State/Region
Postal Code
Country
Select Country...
Australia
Canada
New Zealand
United Kingdom
United States
Citizenship
Citizen of passport country
Citizen of any other country?
Citizenship countries
Australia
Canada
New Zealand
United Kingdom
United States
Pacific-Australian Card
Is the applicant a Pacific-Australia card holder?
Previous travel to Australia
Has this applicant previously travelled to Australia?
Has this applicant previously applied for a visa to Australia?
Grant number
Does this applicant have an Australian visa grant number
Other passports or documents to travel
Do you have any other passports or documents to travel?
Other Identity Documents
List of Documents
+ Add Document
Family Name
Other Names
Given Names
Document Type
Select...
Passport
Drivers License
Photo Card
Number
Country of Issue
Select Country...
Australia
Canada
New Zealand
United Kingdom
United States
Health examination
Have you undertaken a health examination for an Australian visa in the last 12 months?
Travelling Companions
Are there any persons travelling with you to Australia?
Travelling Companion
+ Add Companion
Relationship to Applicant
Given Names
Other Names
Family Name
Date of Birth
Gender
Select...
Male
Female
Prefer Not To Say
Purpose
I intend to enter Australia on multiple occasions
Length of Stay
Select...
3 months
6 months
12 months
Intended Arrival Date
Intended Departure Date
Select the detailed purpose(s) of your visit
Purpose 1
Purpose 2
Purpose 3
Purpose 4
Purpose 5
Purpose 6
Purpose 7
Purpose 8
Purpose 9
Other
Accomodation Type
Select...
Renting
Mortgage
Living with Parents
Home Owner
Other
Street No.
Unit No.
Suite No.
Building No.
Street Name
Street Type
Select...
Road
Street
Avenue
Town/City
State/Region
Postal Code
Country
Select Country...
Australia
Canada
New Zealand
United Kingdom
United States
Study in Australia
Will you undertake a course in Australia?
Relatives, friends or contacts in Australia
Will you visit any relatives, friends or contacts while in Australia?
Contact in Australia
Relationship to Applicant
Family Name
Given Name(s)
Other Name(s)
Gender
Select...
Male
Female
Prefer not to say
Date of Birth
Accomodation Type
Select...
Renting
Mortgage
Living with Parents
Home Owner
Other
Street No.
Unit No.
Suite No.
Building No.
Street Name
Street Type
Select...
Road
Street
Avenue
Town/City
State/Region
Postal Code
Country
Select Country...
Australia
Canada
New Zealand
United Kingdom
United States
Email Address
Mobile Phone Number
Home Phone Number
Work Phone Number
Is the contact an Australian resident?
Will the contact purchase tickets for you back to your home country, if required?
Current Employment
Employment Status
Select...
Full Time
Part Time
Casual
Benefits
Occupation Grouping
Select...
Group One
Group Two
Group Three
Organisation Name
Start Date
Street No.
Unit No.
Suite No.
Building No.
Street Name
Street Type
Select...
Road
Street
Avenue
Town/City
State/Region
Postal Code
Country
Select Country...
Australia
Canada
New Zealand
United Kingdom
United States
Contact Number
Contact Email
Tasks & Duties
+ Add Item
Personal Ties to Home Country
Tie to Home Country
+ Add Tie
Do you have any familial responsibilities?
Do you have assets (real properties and chattels)?
Do you have spouse and children who are not travelling?
Do you have any upcoming events that require your return?
Describe the lifestyle you live in your home country?
Financial Support
Will you have financial support during your stay in Australia?
Relationship to applicant
Funder Family Name
Funder Given Name(s)
Funder Other Name(s)
Funder Street No.
Funder Unit No.
Funder Suite No.
Funder Apartment No.
Funder Street Name
Street Type
Select...
Road
Street
Avenue
Funder Town/City
Funder State/Region
Funder Postal Code
Funder Country
Select Country...
Australia
Canada
New Zealand
United Kingdom
United States
Funder Accomodation Type
Select...
Renting
Mortgage
Living with Parents
Home Owner
Other
Type of Support
Select...
Support Type One
Support Type Two
Support Type Three
Funding Details
+ Add Fund Detail
Available Funds
+ Add Available Fund
Amount (AUD)
$
Details
Health Declarations
In the last five years, have you visited, or lived, outside their country of passport, for more than 3 consecutive months? Do not include time spent in Australia.
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 or train to be, a health care worker or work within a health care facility while in Australia?
Does any applicant intend to work, study or train within aged care or disability care while in Australia?
Has the 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:
a 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 (please list)
Details of other treatement(s)
+ Add Treatment
Does any applicant require ongoing medical care or need special equipment, assistive technology or assistance from others for daily living?
Will you require medical treatment in Australia?
Travel Insurance Details
+ Add Insurance Detail
Character
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 a domestic violence or family violence order, or any other order, of a tribunal or court or other similar authority, for the personal protection of another person?
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)?
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)?
Has 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?
Has any applicant ever had any outstanding debts to the Australian Government or any public authority in Australia?
Have you ever been convicted of a crime?
Imprisonment
+ Add Imprisonment
Nature of offence
Date of offence
Full sentence detail
Imprisonment start date
Imprisonment end date
Visa history
Has the applicant held or does the applicant currently hold a visa to Australia or any other country?
Has the applicant 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 ever had a visa for Australia or any other country refused or cancelled?
Visits to other countries
Visits
+ Add Visit
Country
Select Country...
Australia
Canada
New Zealand
United Kingdom
United States
Date from
Date to
Compliance Status
Select...
Status 1
Status 2
Status 3
Declarations
I declare that the information provided is true and accurate
I understand my obligations as a visa holder
I consent to background and security checks
Save and Continue