Australian Immigration & Citizenship Law Advisers (AICLA)

'INDICATIVE ASSESSMENT' FORM

Sections of this form: (click link to jump to section)

Part A: YOUR DETAILS

Part B: YOUR PARTNER / SPOUSE / DEFACTO's DETAILS (If Applicable)

PART A:  YOUR DETAILS

1a.       Name: (First) (Last) (Middle)

1b.      Sex: (Please select a box)    MALE FEMALE

2.        Address:

3.        Telephone number: (W) (H)

4.        Fax number:          (W)    (H)

5a.        E-mail:   5b.  Mobile/Cell phone:

6a.        Age:                                     6b.  Date of birth:       

6c.        Countries in which you have lived (and years spent in each country) since birth to 18 years old

7.         List all your citizenships/nationalities:

8.         Do you have a current Australian visa? Yes / No

            If 'Yes', What type?     
            Granted where and when?
            Valid until when? 
            Visa expires when? 
            Most revent date you entered Australia (as stamped on your passport)? 

9.         Languages (spoken and written by you)

a.         English language:

             You can speak and write in the English language in
              any situation / most everyday situations / simple situations / none
              (select correct answer).

b.         Name of your Main language:

            spoken level: advanced / intermediate / basic (select correct answer).

            written level:  advanced / intermediate / basic (select correct answer).

c.         Name of your Second language you are most able in:            

            spoken level: advanced / intermediate / basic (select correct answer).

            written level:  advanced / intermediate / basic (select correct answer)

d.         Name of your Third language you are most able in:            

            spoken level: advanced / intermediate / basic (select correct answer).

            written level:  advanced / intermediate / basic (select correct answer)

10.        Qualifications:

            TERTIARY OR POST-SECONDARY (IF NOT, THEN SECONDARY)  

a.         Name of Qualification:

          Type of  qualification: (select correct answer)

            Post-degree Degree   Advanced Diploma Diploma
             Advanced Certificate Certificate

            Full name and address of Institution awarding the qualification:

          Private or Government Institution?
          Number of years studied full-time :
          Commenced studies on (date):
          Finished studies on (date):

 b.         Name of Qualification on certificate:

            Type of  qualification: (select correct answer)

            Post-degree Degree   Advanced Diploma Diploma

            Advanced Certificate Certificate

            Full name and address of Institution awarding the qualification:

          Private or Government Institution?
          Number of years studied full-time :
          Commenced studies on (date):
          Finished studies on (date):

c.         Name of Qualification:

            Type of  qualification: (select correct answer)

            Post-degree Degree   Advanced Diploma Diploma

            Advanced Certificate Certificate

            Full name and address of Institution awarding the qualification:

          Private or Government Institution?
          Number of years studied full-time :
          Commenced studies on (date):
          Finished studies on (date):

11.      Work Experience:

Describe with important details, your main occupation or work (for instance, if employee - the 2 most important or highest positions you hold/held including the main duties/responsibilities for each; if self-employed, the 2 most important or highest positions you hold/held in your business or businesses including the main duties/responsibilities for each position.

a.         Name of position:     

            Period of employment (mmyy) from to

            FULLY LIST the details of duties/responsibilities:

b.         Name of position:     

            Period of employment (mm/yy) from to

            FULLY LIST the details of duties/responsibilities:

12.        Rough estimate (in Australian Dollars) of:

            (a) your Net Asset Value (net worth) (together with your   spouse/partner/defacto):  $

            (b) your monthly income (together with your spouse/partner/defacto):  $

13.        About Your Relationship With Your Spouse/Partner/Defacto (if applicable)

            Do you have a spouse/partner/defacto?  Yes    No    
            If 'Yes', then  over a period of the last 5 years, for how long were you living together?

            (If not continuously, please give full details)

14.        Do you (or your spouse/partner/defacto) have any dependants?  Yes   No

             If 'yes', provide details as to: age? living with you? to be included in visa application?

15a.        Do you (or your spouse/partner/defacto) have any relatives who are:

            Australian citizens/permanent residents? Yes   No

            If 'yes', what type? (eg. brother? cousin? etc)     
           Address (town / state)    

15b.      Do you (or your spouse/partner/defacto) have any children, brothers, sisters, or parents who are NOT Australian citizens/permanent residents? Yes   No

            If 'yes', what type? (eg. brother? parent? cousin? etc)     
           Addresses (town / state)    

16.        Any serious health problems with you or your immediate family members?  Yes   No

            If 'yes', brief description.

17.        Do you or any of your immediate family members have a serious criminal or adverse immigration record (involving any country)?                 Yes   No

            If 'yes', give a brief description:

18.        Do you (or your spouse/partner/defacto) have any refugee or humanitarian claims?

            Yes No

            If 'yes', give a brief description:

19.        IMPORTANT: What are the main reasons for wanting to visit / reside permanently in Australia? (eg. to retire; set up businesses/joint ventures; study; go touring; obtain employment; etc)           

20.        ANY OTHER DETAILS  about your case which you wish to bring to our attention?

PART B:     DETAILS  ABOUT  YOUR  SPOUSE / DEFACTO / PARTNER  (IF APPLICABLE)

21a.        Name of spouse/partner/defacto:

        (First) (Last) (Middle)

21b.      Sex: (Please select a box)    MALE FEMALE

22a.      Age:              22b.  Date of birth:    

23.        List all citizenships/nationalities of your spouse/defacto/partner:          

24.        Does your spouse/defacto/partner have a current Australian visa?

            Yes   No

            If 'Yes', What type?

            Expires when?

25.        Languages (spoken and written by your spouse/partner/defacto)

a.         English language:

             You can speak and write in the English language in
              any situation / most everyday situations / simple situations / none
              (select correct answer).

b.         Name of Spouse Main language:

             spoken level: advanced / intermediate / basic (select correct answer).

            written level:  advanced / intermediate / basic (select correct answer).

c.         Name of spouse Second language you are most able in

             spoken level: advanced / intermediate / basic (select correct answer).

            written level:  advanced / intermediate / basic (select correct answer).

d.         Name of spouse Third language you are most able in:

             spoken level: advanced / intermediate / basic (select correct answer).

            written level:  advanced / intermediate / basic (select correct answer).

26.        Qualifications of spouse/partner/defacto:

            TERTIARY OR POST-SECONDARY (IF NOT, THEN SECONDARY)  

a.         Name of Qualification on Certificate:

            Type of  qualification: (select correct answer)

            Post-degree Degree   Advanced Diploma Diploma

            Advanced Certificate Certificate

            Full name and address of Institution awarding the qualification:

          Private or Government Institution?
          Number of years studied full-time :
          Commenced studies on (date):
          Finished studies on (date):

b.         Name of Qualification:

            Type of  qualification: (select correct answer)

            Post-degree Degree   Advanced Diploma Diploma

            Advanced Certificate Certificate

            Full name and address of Institution awarding the qualification:

          Private or Government Institution?
          Number of years studied full-time :
          Commenced studies on (date):
          Finished studies on (date):

c.         Name of Qualification:

            Type of  qualification: (select correct answer)

            Post-degree Degree   Advanced Diploma Diploma

            Advanced Certificate Certificate

            Full name and address of Institution awarding the qualification:

          Private or Government Institution?
          Number of years studied full-time :
          Commenced studies on (date):
          Finished studies on (date):

27.        Work Experience of spouse/partner/defacto:

Describe with important details, your spouse/partner/defacto's main occupation or work (for instance, if employee - the 2 most important or highest positions he/she holds/held including the main duties/responsibilities for each; if self-employed, the 2 most important or highest positions he/she holds/held in his/her business or businesses including the main duties/responsibilities for each position

a.         Name of position:     

            Period of employment (mmyy) from to

            FULLY LIST the details of duties/responsibilities:

b.         Name of position:     

            Period of employment (mmyy) from to

            FULLY LIST the details of duties/responsibilities: