Longterm

super code

Email Address: *

Confirm Email: *

Dettagli Personali

1

Current location *

Legal status *

Purpose of stay *

Give details of any significant dates in which the applicant needs to be in Australia *

Personal details

Given names *

Family name *

Sex *

Date of birth *

Relationship status *

Your place of birth

Town/City *

State / Province *

Country of birth *

Your country of residence

Select your country of usual residence from the list provided. You will be asked later in this application to provide your full residential address in this country.

Country of residence *

Your passport details

Provide details of the passport that you will use to enter Australia. Enter these details exactly as they appear in your passport. Be very careful when you enter your passport details. This visa is electronic and if you enter the wrong passport number, it means that you have no valid visa for your passport.

Country of passport *

Passport number *

Passport date of issue *

Passport date of expiry *

Passport place of issue *

Are you known by any other names? (This includes names before marriage.) *

Yes
No

Additional name

1	Given names * Family name * Reason for change * Additional comment
1	Given names * Family name * Reason for change * Additional comment

Add

Does this applicant have national identity documents? *

Yes
No

National Identity Document *

1	Given names * Family name * Type of document * Identification number Country of issue *
1	Given names * Family name * Type of document * Identification number Country of issue *

Add Row

Has this applicant previously travelled to Australia or previously applied for a visa? *

Yes
No

Does this applicant have expired passports that were previously used to travel to Australia? *

Yes
No

Expired passports

Enter details exactly as shown on the passport.

Given names *

Family name *

Sex *

Date of birth *

Country of passport *

Passport number *

Passport date of issue *

Passport date of expiry *

Passport place of issue *

Does this applicant have an Australian visa grant number? *

No
Yes

Australian visa grant number *

Does this applicant have an Australian visa label in their current or previous passport? *

No
Yes

Australian visa label number *

Are you a citizen of a country other than the one on your passport? *

Yes
No

Country *

Are there any other persons travelling with the applicant to Australia? *

Yes
No

Travelling companion

1	Relationship to the applicant * Given names * Family name * Sex * Date of birth *
1	Relationship to the applicant * Given names * Family name * Sex * Date of birth *

Add

Contact details

Country of residence *

Address *

Suburb/Town *

province *

Postcode *

Home phone *

Work phone *

Mobile/Cell (please include country code) *

Does the applicant have any family members not travelling to Australia who are not Australian citizens or Australian permanent residents? *

Yes
No

Non-accompanying family members *

1	About the family member: Relationship to the applicant * Given names * Family name * Sex * Date of birth * Country of birth *
1	About the family member: Relationship to the applicant * Given names * Family name * Sex * Date of birth * Country of birth *

Add

Proposed period of stay

Date from *

Date to *

Length of stay in Australia *

Does the applicant have health insurance arranged for their stay in Australia

Yes
No

Give details of any health insurance arraged for the applicant's stay in Australia.

Type of health insurance cover

Name of health insurer

Date from

Date to

Does the applicant intend to enter Australia on more than one occasion? *

Yes
No

Does the applicant know the dates of entry for each occasion after first entry to Australia? *

Yes
No

Give reason *

Give details of the additional entry *

1	Date from * Date to * Give reason *
1	Date from * Date to * Give reason *

Add

Will the applicant undertake a course of study in Australia? *

Yes
No

Give details of the course the applicant is undertaking *

1	Course name * Institution name * Date from * Date to *
1	Course name * Institution name * Date from * Date to *

Add

Will the applicant visit any relatives, friends or contacts while in Australia? *

Yes
No

Relationship to the applicant *

Given names *

Family name *

Sex *

Date of birth *

Country of residence *

Address *

Suburb/Town *

province *

Postcode *

Home phone *

Work phone

Mobile/Cell (please include country code)

Email address

Fax number

Australian residency status *

Employment

What is your employment status? *

Give details of your employer

Name *

Address *

Suburb/Town *

State or Province *

Postcode *

Country *

Telephone number *

Please describe the nature or type of business *

Job title / Position *

Occupation *

How long have you been employed by this employer / business?

How long have you been self-employed?

years *

months *

What year did you retire? *

What was your last employment position? *

Give details of your course

Name of your current course *

Name of institution providing your current course *

How long have you been studying at this institution?

years *

months *

How long have you been unemployed?

years *

months *

What was your last employment position? *

Give details of your employment status including commencement and completion (if applicable) dates. *

Give details of how the stay in Australia will be funded *

What funds will the applicant have available to support their stay in Austrialia? *

Health declarations *

You are required to answer the following questions for yourself and any other person included in the application

In the last 5 years, have you visited, or lived, outside your country of residence for more than 3 consecutive months (other than in Australia)? *

Yes
No

Details of visit to other country? *

1	Name * Country visited * Date from * Date to *
1	Name * Country visited * Date from * Date to *

Add Row

Do you intend to enter a hospital or a health care facility (including nursing homes) while in Australia? *

Yes
No

Reason *

Details *

Do you intend to work as, or study to be, or train to be, a doctor, dentist, nurse or paramedic during your stay in Australia? *

Yes
No

Details *

Have you 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? *

Yes
No

Exposure to tuberculosis *

Name *

Details *

Expected medical costs *

During your proposed visit to Australia, do you expect to incur medical costs, or require treatment or medical follow up for:

blood disorder *

Yes
No

Expect to incur medical costs *

Name *

Details *

cancer *

Yes
No

Expect to incur medical costs *

Name *

Details *

heart disease *

Yes
No

Expect to incur medical costs *

Name *

Details *

hepatitis B or C *

Yes
No

Expect to incur medical costs *

Name *

Details *

liver disease *

Yes
No

Expect to incur medical costs *

Name *

Details *

HIV infection, including AIDS *

Yes
No

Expect to incur medical costs *

Name *

Details *

kidney disease, including dialysis *

Yes
No

Expect to incur medical costs *

Name *

Details *

mental illness *

Yes
No

Expect to incur medical costs *

Name *

Details *

pregnancy *

Yes
No

Expect to incur medical costs *

Name *

Details *

respiratory disease that has required hospital admission or oxygen therapy *

Yes
No

Expect to incur medical costs *

Name *

Details *

Expect to incur medical costs *

other? *

Yes
No

Expect to incur medical costs *

Name *

Details *

Do you require assistance with mobility or care due to a medical condition? *

Yes
No

Care and/or mobility needs due to a medical condition *

Name *

Details *

About immunisation: *

Visa applicants are encouraged to be immunised against infectious diseases before travelling to Australia. Visa applicants who are unable to arrange their immunisation before departure from their home country are encouraged to seek advice on arrival in Australia. The Australian state and territory health authorities assist people to obtain general medical help and advice, including immunisation. Parents are strongly encouraged to have their children immunised against hepatitis B, diphtheria, tetanus, pertussis (whooping cough), poliomyelitis, haemophilus influenzae type-b (Hib), pneumococcal and meningococcal infections, mumps, measles, rubella and varicella (chickenpox). Babies between the ages of 2 and 8 months of age (only) are also encouraged to be immunised against rotavirus.

Parents should bring any immunisation records for their children with them to Australia.

Rubella vaccinations are strongly encouraged for women of child-bearing age.

Character declarations *

Have you, ever:

been convicted of a crime or offence in any country (including any conviction which is now removed from official records)? *

Yes
No

If Yes, please give details *

been charged with any offence that is currently awaiting legal action? *

Yes
No

If Yes, please give details *

been acquitted of any criminal offence or other offence on the grounds of mental illness, insanity or unsoundness of mind? *

Yes
No

If Yes, please give details *

been removed or deported from any country (including Australia)? *

Yes
No

If Yes, please give details *

been refused a visa for Australia or another country? *

Yes
No

If Yes, please give details *

left any country to avoid being removed or deported? *

Yes
No

If Yes, please give details *

been excluded from or asked to leave any country (including Australia)? *

Yes
No

If Yes, please give details *

committed, or been involved in the commission of war crimes or crimes against humanity or human rights? *

Yes
No

If Yes, please give details *

been involved in any activities that would represent a risk to Australian national security? *

Yes
No

If Yes, please give details *

had any outstanding debts to the Australian Government or any public authority in Australia? *

Yes
No

If Yes, please give details *

been involved in any activity, or been convicted of any offence, relating to the illegal movement of people to any country (including Australia)? *

Yes
No

If Yes, please give details *

served in a military force or state-sponsored or private militia, or undergone any military or paramilitary training, or been trained in weapons or explosives use (however described), other than in the course of compulsory national military service? *

Yes
No

Name *

Country *

Date from *

Date to *

Additional Information *

Declaration *

I certify that: *

I have read and understood the information provided in this application. *

Yes
No

Have provided complete and correct information in every detail on this form, and on any attachments to it. *

Yes
No

I understand that if any fraudulent or misleading documents or information is found, this application is likely to be refused and I may become ineligible to be granted a travel visa for a certain period of time. *

Yes
No

I will inform the Department of Immigration and Citizenship in writing immediately as I become aware of a change in circumstances (including change of address) or if there is any change relating to information I4 have provided in or with this application, while it is being considered. *

Yes
No

I understand that if a "no further stay" condition (8503) is imposed on this visa, it will limit my ability to remain in Australia beyond the period authorised by the travel visa. *

Yes
No

Agree not to undertake study or training for more than three months. *

Yes
No

Agree to leave Australia on or before the expiry of the period of stay of the visa. *

Yes
No

I understand that, if required to provide my fingerprints and facial image, the fingerprints and facial image and biographical information held by the Department of Immigration and Citizenship may be given to Australian law enforcement agencies to help identify me and determine eligibility for grant of the visa being applied for, and for law enforcement purposes. *

Yes
No

Give consent to Australian law enforcement agencies disclosing the applicant’s biometric, biographical and criminal record information to the Department of Immigration and Citizenship to help identify the applicant, to determine eligibility for grant of a visa and for law enforcement purposes. *

Yes
No

Give consent to the Department of Immigration and Citizenship using the applicant’s biometric, biographical and criminal record information obtained for the purposes of the Migration Act 1958 or the Citizenship Act 2007. *

Yes
No

Document upload: Copy of passport ID page *

Please upload the copy of your passport ID page: select file and press upload to submit your document.

Document upload *

File name:

File size:

1

Current location *

Legal status *

Purpose of stay *

Give details of any significant dates in which the applicant needs to be in Australia *

Personal details

Given names *

Family name *

Sex *

Date of birth *

Relationship status *

Your place of birth

Town/City *

State / Province *

Country of birth *

Your country of residence

Select your country of usual residence from the list provided. You will be asked later in this application to provide your full residential address in this country.

Country of residence *

Your passport details

Provide details of the passport that you will use to enter Australia. Enter these details exactly as they appear in your passport. Be very careful when you enter your passport details. This visa is electronic and if you enter the wrong passport number, it means that you have no valid visa for your passport.

Country of passport *

Passport number *

Passport date of issue *

Passport date of expiry *

Passport place of issue *

Are you known by any other names? (This includes names before marriage.) *

Yes
No

Additional name

1	Given names * Family name * Reason for change * Additional comment
1	Given names * Family name * Reason for change * Additional comment

Add

Does this applicant have national identity documents? *

Yes
No

National Identity Document *

1	Given names * Family name * Type of document * Identification number Country of issue *
1	Given names * Family name * Type of document * Identification number Country of issue *

Add Row

Has this applicant previously travelled to Australia or previously applied for a visa? *

Yes
No

Does this applicant have expired passports that were previously used to travel to Australia? *

Yes
No

Expired passports

Enter details exactly as shown on the passport.

Given names *

Family name *

Sex *

Date of birth *

Country of passport *

Passport number *

Passport date of issue *

Passport date of expiry *

Passport place of issue *

Does this applicant have an Australian visa grant number? *

No
Yes

Australian visa grant number *

Does this applicant have an Australian visa label in their current or previous passport? *

No
Yes

Australian visa label number *

Are you a citizen of a country other than the one on your passport? *

Yes
No

Country *

Are there any other persons travelling with the applicant to Australia? *

Yes
No

Travelling companion

1	Relationship to the applicant * Given names * Family name * Sex * Date of birth *
1	Relationship to the applicant * Given names * Family name * Sex * Date of birth *

Add

Contact details

Country of residence *

Address *

Suburb/Town *

province *

Postcode *

Home phone *

Work phone *

Mobile/Cell (please include country code) *

Does the applicant have any family members not travelling to Australia who are not Australian citizens or Australian permanent residents? *

Yes
No

Non-accompanying family members *

1	About the family member: Relationship to the applicant * Given names * Family name * Sex * Date of birth * Country of birth *
1	About the family member: Relationship to the applicant * Given names * Family name * Sex * Date of birth * Country of birth *

Add

Proposed period of stay

Date from *

Date to *

Length of stay in Australia *

Does the applicant have health insurance arranged for their stay in Australia

Yes
No

Give details of any health insurance arraged for the applicant's stay in Australia.

Type of health insurance cover

Name of health insurer

Date from

Date to

Does the applicant intend to enter Australia on more than one occasion? *

Yes
No

Does the applicant know the dates of entry for each occasion after first entry to Australia? *

Yes
No

Give reason *

Give details of the additional entry *

1	Date from * Date to * Give reason *
1	Date from * Date to * Give reason *

Add

Will the applicant undertake a course of study in Australia? *

Yes
No

Give details of the course the applicant is undertaking *

1	Course name * Institution name * Date from * Date to *
1	Course name * Institution name * Date from * Date to *

Add

Will the applicant visit any relatives, friends or contacts while in Australia? *

Yes
No

Relationship to the applicant *

Given names *

Family name *

Sex *

Date of birth *

Country of residence *

Address *

Suburb/Town *

province *

Postcode *

Home phone *

Work phone

Mobile/Cell (please include country code)

Email address

Fax number

Australian residency status *

Employment

What is your employment status? *

Give details of your employer

Name *

Address *

Suburb/Town *

State or Province *

Postcode *

Country *

Telephone number *

Please describe the nature or type of business *

Job title / Position *

Occupation *

How long have you been employed by this employer / business?

How long have you been self-employed?

years *

months *

What year did you retire? *

What was your last employment position? *

Give details of your course

Name of your current course *

Name of institution providing your current course *

How long have you been studying at this institution?

years *

months *

How long have you been unemployed?

years *

months *

What was your last employment position? *

Give details of your employment status including commencement and completion (if applicable) dates. *

Give details of how the stay in Australia will be funded *

What funds will the applicant have available to support their stay in Austrialia? *

Health declarations *

You are required to answer the following questions for yourself and any other person included in the application

In the last 5 years, have you visited, or lived, outside your country of residence for more than 3 consecutive months (other than in Australia)? *

Yes
No

Details of visit to other country? *

1	Name * Country visited * Date from * Date to *
1	Name * Country visited * Date from * Date to *

Add Row

Do you intend to enter a hospital or a health care facility (including nursing homes) while in Australia? *

Yes
No

Reason *

Details *

Do you intend to work as, or study to be, or train to be, a doctor, dentist, nurse or paramedic during your stay in Australia? *

Yes
No

Details *

Have you 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? *

Yes
No

Exposure to tuberculosis *

Name *

Details *

Expected medical costs *

During your proposed visit to Australia, do you expect to incur medical costs, or require treatment or medical follow up for:

blood disorder *

Yes
No

Expect to incur medical costs *

Name *

Details *

cancer *

Yes
No

Expect to incur medical costs *

Name *

Details *

heart disease *

Yes
No

Expect to incur medical costs *

Name *

Details *

hepatitis B or C *

Yes
No

Expect to incur medical costs *

Name *

Details *

liver disease *

Yes
No

Expect to incur medical costs *

Name *

Details *

HIV infection, including AIDS *

Yes
No

Expect to incur medical costs *

Name *

Details *

kidney disease, including dialysis *

Yes
No

Expect to incur medical costs *

Name *

Details *

mental illness *

Yes
No

Expect to incur medical costs *

Name *

Details *

pregnancy *

Yes
No

Expect to incur medical costs *

Name *

Details *

respiratory disease that has required hospital admission or oxygen therapy *

Yes
No

Expect to incur medical costs *

Name *

Details *

Expect to incur medical costs *

other? *

Yes
No

Expect to incur medical costs *

Name *

Details *

Do you require assistance with mobility or care due to a medical condition? *

Yes
No

Care and/or mobility needs due to a medical condition *

Name *

Details *

About immunisation: *

Visa applicants are encouraged to be immunised against infectious diseases before travelling to Australia. Visa applicants who are unable to arrange their immunisation before departure from their home country are encouraged to seek advice on arrival in Australia. The Australian state and territory health authorities assist people to obtain general medical help and advice, including immunisation. Parents are strongly encouraged to have their children immunised against hepatitis B, diphtheria, tetanus, pertussis (whooping cough), poliomyelitis, haemophilus influenzae type-b (Hib), pneumococcal and meningococcal infections, mumps, measles, rubella and varicella (chickenpox). Babies between the ages of 2 and 8 months of age (only) are also encouraged to be immunised against rotavirus.

Parents should bring any immunisation records for their children with them to Australia.

Rubella vaccinations are strongly encouraged for women of child-bearing age.

Character declarations *

Have you, ever:

been convicted of a crime or offence in any country (including any conviction which is now removed from official records)? *

Yes
No

If Yes, please give details *

been charged with any offence that is currently awaiting legal action? *

Yes
No

If Yes, please give details *

been acquitted of any criminal offence or other offence on the grounds of mental illness, insanity or unsoundness of mind? *

Yes
No

If Yes, please give details *

been removed or deported from any country (including Australia)? *

Yes
No

If Yes, please give details *

been refused a visa for Australia or another country? *

Yes
No

If Yes, please give details *

left any country to avoid being removed or deported? *

Yes
No

If Yes, please give details *

been excluded from or asked to leave any country (including Australia)? *

Yes
No

If Yes, please give details *

committed, or been involved in the commission of war crimes or crimes against humanity or human rights? *

Yes
No

If Yes, please give details *

been involved in any activities that would represent a risk to Australian national security? *

Yes
No

If Yes, please give details *

had any outstanding debts to the Australian Government or any public authority in Australia? *

Yes
No

If Yes, please give details *

been involved in any activity, or been convicted of any offence, relating to the illegal movement of people to any country (including Australia)? *

Yes
No

If Yes, please give details *

served in a military force or state-sponsored or private militia, or undergone any military or paramilitary training, or been trained in weapons or explosives use (however described), other than in the course of compulsory national military service? *

Yes
No

Name *

Country *

Date from *

Date to *

Additional Information *

Declaration *

I certify that: *

I have read and understood the information provided in this application. *

Yes
No

Have provided complete and correct information in every detail on this form, and on any attachments to it. *

Yes
No

I understand that if any fraudulent or misleading documents or information is found, this application is likely to be refused and I may become ineligible to be granted a travel visa for a certain period of time. *

Yes
No

I will inform the Department of Immigration and Citizenship in writing immediately as I become aware of a change in circumstances (including change of address) or if there is any change relating to information I4 have provided in or with this application, while it is being considered. *

Yes
No

I understand that if a "no further stay" condition (8503) is imposed on this visa, it will limit my ability to remain in Australia beyond the period authorised by the travel visa. *

Yes
No

Agree not to undertake study or training for more than three months. *

Yes
No

Agree to leave Australia on or before the expiry of the period of stay of the visa. *

Yes
No

I understand that, if required to provide my fingerprints and facial image, the fingerprints and facial image and biographical information held by the Department of Immigration and Citizenship may be given to Australian law enforcement agencies to help identify me and determine eligibility for grant of the visa being applied for, and for law enforcement purposes. *

Yes
No

Give consent to Australian law enforcement agencies disclosing the applicant’s biometric, biographical and criminal record information to the Department of Immigration and Citizenship to help identify the applicant, to determine eligibility for grant of a visa and for law enforcement purposes. *

Yes
No

Give consent to the Department of Immigration and Citizenship using the applicant’s biometric, biographical and criminal record information obtained for the purposes of the Migration Act 1958 or the Citizenship Act 2007. *

Yes
No

Document upload: Copy of passport ID page *

Please upload the copy of your passport ID page: select file and press upload to submit your document.

Document upload *

File name:

File size:

Add Row

Tracking Code

Visa Type

Validate Email

Australian Government official resources: