Australian Second Working Holiday Visa Application Form (US Citizens)

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Dettagli Personali

1

Personal details

Given names *

Family name *

Sex *

Date of birth *

Relationship status *

Telephone number *

Your place of birth

Town/City *

State / Province *

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.

Country of passport *

Passport number *

Passport date of issue *

Passport date of expiry *

Passport place of issue *

If you have a current Australian visa label in your current or previous passport, please enter the visa number *

Health Examination

Have you undertaken a health examination for an Australian visa in the past 12 months? *

Yes
No

If Yes, please give details

Please enter the HAP ID (if known)

When do you propose to enter Australia using the visa that you are applying for now? *

Do you have any dependent children? *

Yes
No

You are not eligible to use this service, as applicants for this visa must not have dependent children.

Have you undertaken specified work in regional Australia for a total of 3 months? *

Yes
No

If Yes, in which industry did this work mainly occur?

specific work

1	Details of specified work undertaken Please provide the Australian Business Number (ABN) and location postcode of the employer, and start and end date(s) of the specified work for each employer. ABN Postcode Date from Date to
1	Details of specified work undertaken Please provide the Australian Business Number (ABN) and location postcode of the employer, and start and end date(s) of the specified work for each employer. ABN Postcode Date from Date to

Add Row

Do you have approved evidence that you have undertaken specified work ("specified work") in regional Australia for a total of 3 months? *

Yes
No

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

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

Yes
No

Other citizenship

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

Have you been granted and entered Australia on a Work and Holiday visa (subclass 462) before? *

Yes
No

You are not eligible to use this service

Your personal details (continued)

What is your usual occupation? *

What industry do you intend to seek employment in? *

What is your highest qualification? *

Residential address details

Give details of the residential address in your home country.

Address *

Suburb/Town *

State or Province *

Postcode *

Country *

Mobile/Cell phone (please include country code) *

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

Do you intend to work, or be a trainee, at a child care centre (including preschools and creches) while in Australia? *

Yes
No

Childcare centres including preschools and creches

Institution (if known)

Role *

Details

Do you intend to be in a classroom situation for more than 3 months (e.g. as either a student, teacher, lecturer, or observer) while in Australia? *

Yes
No

Classroom situations

Name of course

Name of institution providing course

Total course length for the duration of your stay (in weeks)

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

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

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

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.

Care and/or mobility needs due to a medical condition

Name

Details

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 understand the information provided to me at the beginning of application, I am aware of the conditions that will apply to my visa and that I am required to abide by them. *

Yes
No

I understand that the visa I am applying for does not permit me to be employed in Australia with one employer for more than 6 months. *

Yes
No

I understand that the visa I am applying for does not permit me to undertake studies or training for more than 4 months. *

Yes
No

I have sufficient funds for the initial period of my stay in Australia and for the fare to my intended overseas destination on leaving Australia. *

Yes
No

Any employment is incidental to my holiday in Australia and the purpose of working is to supplement my holiday funds. *

Yes
No

I am applying for a Working Holiday visa for the first time and have not previously entered Australia on a Working Holiday visa (on a passport of any country). *

Yes
No

I will respect Australian values as listed at the beginning of this application, during my stay in Australia and will obey the laws of Australia. *

Yes
No

I have truthfully declared all relevant details required of me in this application. *

Yes
No

If granted a visa, I will advise the Australian Government of any change in my circumstances. *

Yes
No

1

Personal details

Given names *

Family name *

Sex *

Date of birth *

Relationship status *

Telephone number *

Your place of birth

Town/City *

State / Province *

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.

Country of passport *

Passport number *

Passport date of issue *

Passport date of expiry *

Passport place of issue *

If you have a current Australian visa label in your current or previous passport, please enter the visa number *

Health Examination

Have you undertaken a health examination for an Australian visa in the past 12 months? *

Yes
No

If Yes, please give details

Please enter the HAP ID (if known)

When do you propose to enter Australia using the visa that you are applying for now? *

Do you have any dependent children? *

Yes
No

You are not eligible to use this service, as applicants for this visa must not have dependent children.

Have you undertaken specified work in regional Australia for a total of 3 months? *

Yes
No

If Yes, in which industry did this work mainly occur?

specific work

1	Details of specified work undertaken Please provide the Australian Business Number (ABN) and location postcode of the employer, and start and end date(s) of the specified work for each employer. ABN Postcode Date from Date to
1	Details of specified work undertaken Please provide the Australian Business Number (ABN) and location postcode of the employer, and start and end date(s) of the specified work for each employer. ABN Postcode Date from Date to

Add Row

Do you have approved evidence that you have undertaken specified work ("specified work") in regional Australia for a total of 3 months? *

Yes
No

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

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

Yes
No

Other citizenship

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

Have you been granted and entered Australia on a Work and Holiday visa (subclass 462) before? *

Yes
No

You are not eligible to use this service

Your personal details (continued)

What is your usual occupation? *

What industry do you intend to seek employment in? *

What is your highest qualification? *

Residential address details

Give details of the residential address in your home country.

Address *

Suburb/Town *

State or Province *

Postcode *

Country *

Mobile/Cell phone (please include country code) *

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

Do you intend to work, or be a trainee, at a child care centre (including preschools and creches) while in Australia? *

Yes
No

Childcare centres including preschools and creches

Institution (if known)

Role *

Details

Do you intend to be in a classroom situation for more than 3 months (e.g. as either a student, teacher, lecturer, or observer) while in Australia? *

Yes
No

Classroom situations

Name of course

Name of institution providing course

Total course length for the duration of your stay (in weeks)

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

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

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

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.

Care and/or mobility needs due to a medical condition

Name

Details

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 understand the information provided to me at the beginning of application, I am aware of the conditions that will apply to my visa and that I am required to abide by them. *

Yes
No

I understand that the visa I am applying for does not permit me to be employed in Australia with one employer for more than 6 months. *

Yes
No

I understand that the visa I am applying for does not permit me to undertake studies or training for more than 4 months. *

Yes
No

I have sufficient funds for the initial period of my stay in Australia and for the fare to my intended overseas destination on leaving Australia. *

Yes
No

Any employment is incidental to my holiday in Australia and the purpose of working is to supplement my holiday funds. *

Yes
No

I am applying for a Working Holiday visa for the first time and have not previously entered Australia on a Working Holiday visa (on a passport of any country). *