澳大利亚签证1221表

Additional personal particularsinformationForm1221About this formThis is a supplementary form required to support your visa application and is to be completed by all applicants who are 18 years of age or over.Important – Please read this information carefully before you complete this form. Once you have completed this form we strongly advise that you keep a copy for your records.Integrity of applicationThe Department of Immigration and Border Protection(the department) is committed to maintaining the integrity of the visa and citizenship programs. Please be aware that if you provide us with fraudulent documents or claims, this may result in processing delays and possibly your application being refused.Important information about privacyYour personal information is protected by law, including the Privacy Act 1988. Important information about the collection, use and disclosure (to other agencies and third parties, including overseas entities) of your personal information, including sensitive information, is contained in form 1442i Privacy notice . Form 1442i is available from the department’s website .au/allforms/ or offices of thedepartment. You should ensure that you read and understandform 1442i before completing this form.Tick where applicablePlease use a pen, and write neatly in English using BLOCK LETTERS.Part A – Your details.auTelephone 131 881 during business hours in Australia to speak to an operator (recordedinformation available outside these hours). If you are outside Australia, please contact your nearest Australian mission.Home page Generalenquiry line Family name Given names13Your full name(as shown in your passport or travel document)Name in your own language or script(if applicable)2Other names you are, or have been, known by(including name at birth, previous married names, aliases)MaleFemale6Place of birth 5Date of birth7Sex 8Relationship statusMarried De factoEngagedDivorced SeparatedWidowedrelationship9Citizenship or nationality (give details of all held)Date granted4Name in Chinese Commercial Code Numbers(if applicable)CountryState/province/regionSuburb andtown/city11Your contact detailsHome telephone Mobile/cell All emailaddressesIf insufficient space, give details at Part O – Additional details12Your proposed residential address in Australia (if known)Passport/travel document number 13Details from your passport/travel documentPlace of issue/issuing authorityDate of issue Date of expiry Part B – Travel detailsCountry of passport/travel document10Your current residential address (this is the place where you currently live)Note : A post office box, migration agent address or mailbox address is not acceptable as a residential address. Unit/Apartment numberPostal codeAddress (include street number and name)Country State/province/region Suburb and town/city15Have you ever had a visa refused or cancelled by, been refused entry to, or been deported from, any country?Give details of dates, countries and circumstances(If insufficient space, give details at Part O – Additional details)Give details in chronological order(If insufficient space, give details at Part O – Additional details)NoYesHave you previously held an Australian visa?16Give detailsNoYesDo you currently have, or have you ever had, any national identity documents or numbers(including birth registration numbers, social security cards etc)?1417What is the general purpose of your journey/further stay?18If you are outside Australia, give details of your intended arrivalIntended date of arrivalFlight number or vessel details (if known)19Intended date of departureNo Yes20Give details of any intended stopovers on your way to AustraliaPlaces of intended stopovers21Give details of any proposed onward locations after your departurefrom Australia22Are you fully funding your trip?NoYesGive details of the person/institution funding your tripFull nameName of institution (if applicable)AddressTelephone numberEmail address of person/institutionPart C – Details of travelling dependents/family members23Give details of dependents/family members travelling to Australia with youGiven namesFamily name Date of birth Relationship to you (eg. partner, sister, aunt)1.Suburb and town/city of birthCountry of birthPart D – Current employment detailsEmployment commenced Name of employerAddress of employerContact telephoneEmail address (if applicable)Type of business Occupation/Position Detailed job description24Are you currently employedGive details of your current employmentYes Given namesFamily name Date of birth Relationship to you (eg. partner, sister, aunt)2.Country of birthIf insufficient space, give details at Part O – Additional detailsNoGive details of how you occupy your time and how you support yourselfSuburb and town/city of birth25Give details of your employment status in the last 10 years (including internships, work experience, self employment and periods of unemployment)Part F – Military service26Have you had any military service?Give details in chronological order(If insufficient space, give details at Part O – Additional details)No YesPart E – Employment status in the last 10 yearsPart G – Education and trade qualifications27Give details of all post secondary qualifications(list your most recent experience first)Institution and city/campus1.Year of awardQualificationMain subjects or dutiesInstitution and city/campus2.Year of awardQualificationMain subjects or dutiesInstitution and city/campus3.Year of awardQualificationMain subjects or dutiesInstitution and city/campus4.Year of awardQualification Main subjects or dutiesIf insufficient space, give details at Part O – Additional details28Describe any workshops, training, conferences or seminars you haveattended in the last 2 years29List all titles and describe any previous academic or research papersyou have had publishedPart H – Details of your contact in Australia30Do you have contacts in Australia (including your sponsor, businesscontacts, the person you will be staying with, a family relative or an educational institution)?NoYesGo to Part I Family nameGiven namesNature of relationship to you31Current residential address of your contact(a post office box address is not acceptable as a residential address)34Part I – Details of your journey to AustraliaOnly complete the section(s) relevant to youIf you:Visitor visaBusiness visaMigration visaresearcher or fellowGo to Part J Go to Part K Go to Part LGo to Part M3537Part J – Visitor visaDo you intend to do a course of study while in Australia?Are you attending a conference/seminar in Australia?No YesGive detailsName of course Name of the institutionType of course32Contact’s telephone numbersTelephone numberMobile33Contact’s current employment detailsName of employerAddress of employerType of business Occupation/Position Duties36Proposed employment/business activity detailsName of employer Address of employmentNature of employment/business activities Proposed duties/activitiesPart K – Business visaNo YesGive full name of conference and (if applicable) attach an abstract of the conference presentation38Do you intend to inspect and/or negotiate the purchase of anyequipment during your stay in Australia? No YesGive detailsAll email addresses414042Part M –Student/Academic/Researcher/FellowsGive details of your proposed course/field of study in Australia(including name of course, type of course, thesis topic and research to be undertaken)Do you intend to work in Australia?Do you intend to work in Australia?Name of employer Name of employer Address of employerAddress of employerType of business Type of business Occupation/Position Occupation/Position DutiesDuties39Part L – Migration visasDo you intend to do a course of study while in Australia?No No No YesYesYesIf you have organised your course, give details belowIf you have organised your employment, give details belowIf you have organised your employment, give details belowName of course Name of the institutionType of courseFamily name Given namesName of supervisor (if applicable)Part N – Additional information43Give details of how you intend to use the knowledge/skills/researchobtained once you depart Australia44Are there any other details you would like taken into consideration?46Part P – DeclarationI declare that:• the information I have supplied in this application is complete, correct and up-to-date in every detail.• I have read and understood the information supplied to me.• I have read the information contained in form 1442i Privacy notice.• I understand the department may collect, use and disclose my personal information (including biometric information and other sensitive information) as outlined in form 1442i Privacy notice. WARNING: Giving false or misleading information is a serious offence.Part O – Additional details45Signature ofapplicantDateWe strongly advise that you keep a copy of your applicationand all attachments for your records.。