ASSESSMENT QUESTIONNAIRE

Personal Details

Title

Full Name

First Name

Last Name

Date of Birth

YYYY

Gender

Marital Status

Mobile Number

Country

(###)

###

####

Current Address

(House/ Apartment Number, Street Name, Suburb/ Town, State, Postcode & Country)

Country of Citizenship(s)

Family Members

Do you have a partner?

If yes, would you like your partner to migrate with you?

Do you have children?

If yes, how many children do you have?

If yes, would you like your children to migrate with you?

If yes, how old are your children?

Passport Details

Passport Number

Country of Passport

Issue Date

YYYY

Expiry Date

YYYY

Australian Visa Details

Do you currently or previously hold an Australian visa?

Visa Subclass

Issue Date

YYYY

Expiry Date

YYYY

Health Details

Do you (or anyone in your family) have any health or medical issues?

If yes, please provide further details

Character Details

Have you ever (or anyone in your family) been charged or convicted of a crime/ offence in any country (including Australia)?

If yes, please provide further details

Have you (or any of your family) ever been refused or cancelled a visa, or denied entry in any countries (including Australia)?

If yes, please provide further details

Educational Background

Qualification Level - 1

Name of Course

Name of Institution

Country of Institution

Year Completed

Qualification Level - 2

Name of Course

Name of Institution

Country of Institution

Year Completed

Qualification Level - 3

Name of Course

Name of Institution

Country of Institution

Year Completed

Employment Background

Employer Name - 1

Position/ Occupation

Employment Basis

Country of Employer

Date From

YYYY

Date To

YYYY

Would this employer sponsor you for an Australian work visa?

(If applicable)

Can you obtain an employment reference letter from this employer?

Can you provide evidence of pay from this employer?

(This can include payslips, bank statements, tax documents, etc.)

Duties and Responsibilities

Employer Name - 2

Position/ Occupation

Employment Basis

Country of Employer

Date From

YYYY

Date To

YYYY

Would this employer sponsor you for an Australian work visa?

(If applicable)

Can you obtain an employment reference letter from this employer?

Can you provide evidence of pay from this employer?

(This can include payslips, bank statements, tax documents, etc.)

Duties and Responsibilities

Employer Name - 3

Position/ Occupation

Employment Basis

Country of Employer

Date From

YYYY

Date To

YYYY

Would this employer sponsor you for an Australian work visa?

(If applicable)

Can you obtain an employment reference letter from this employer?

Can you provide evidence of pay from this employer?

(This can include payslips, bank statements, tax documents, etc.)

Duties and Responsibilities

Employer Name - 4

Position/ Occupation

Employment Basis

Country of Employer

Date From

YYYY

Date To

YYYY

Would this employer sponsor you for an Australian work visa?

(If applicable)

Can you obtain an employment reference letter from this employer?

Can you provide evidence of pay from this employer?

(This can include payslips, bank statements, tax documents, etc.)

Duties and Responsibilities

Employer Name - 5

Position/ Occupation

Employment Basis

Country of Employer

Date From

YYYY

Date To

YYYY

Would this employer sponsor you for an Australian work visa?

(If applicable)

Can you obtain an employer reference from this employer?

Can you provide evidence of pay from this employer?

(This can include payslips, bank statements, tax documents, etc.)

Duties and Responsibilities

Occupational Registration/ Licensing/ Professional Membership

Name of Authority

Type of Registration/ License/ Membership

Occupation

Country of Registration/ License/ Membership

Issue Date

YYYY

English Test Details

Have you undertaken an English Test in the last 3 years?

Name of Test

Date of Test

YYYY

English Test Score

(Listening, Reading, Writing, Speaking & Overall Score)

Family in Australia

Do you have family in Australia?

(If yes, please provide details of your family in Australia)

Relationship

Title

Full Name

First Name

Last Name

Country of Citizenship(s)

Australian Residency Status

Address

(House/ Apartment Number, Street Name, Suburb/ Town, State, Postcode & Country)

If your family member is your Partner/ Spouse

When did you first meet?

YYYY

If de-facto - when did you first start living together?

YYYY

If engaged - when are you planning to get married?

YYYY

If married - when did you get married?

YYYY

What are yours and your partner/ spouse's current living situation?

Do you and your partner/ spouse share financial expenses? If yes, how do you manage your expenses?

Do you have children together?

If yes, how many children do you have together?

Have you and your partner been separated at any periods of time during your relationship?

If yes, please provide further details

Has your partner/ spouse ever been charged or convicted of a crime or offence in any country (including Australia)?

If yes, please provide further details

Has your partner/ spouse been in a de-facto, engaged or married relationship previously?

If yes, please provide further details

(Please provide the date your relationship began and ended, why the relationship broke down and if there were children)

Consultation Availability

We will require at least 1-2 business days to review your information and prepare for your consultation. We note, our preferred availability for consultation is between 9am to 5pm (Australian Eastern Standard Time - AEST), Monday to Friday. Consultations booked outside these hours occur additional costs. Please advise three preferred dates/ times you would be available.

First Preference

Date

YYYY

Time

Hour

Minute

Second

Second Preference

Date

YYYY

Time

Hour

Minute

Second

Third Preference

Date

YYYY

Time

Hour

Minute

Second

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