Professional Documents
Culture Documents
Application Ap tion for a Visitor visa Tourist stream Visit Visito a Tour Touris am m
Form
1419 1419
Please se use a pen, and a w e neatly atly in English using u OCK LETTERS. write BLOCK Tick ck k where applicable applica a
Indicate ndicate ate if you u are a applying i outside de Australia or in Australia: A ralia: Outside A Australia Aus In n Aus Australia Austral Go to Question 2 Go t to Question uestion 5 uesti
Give e the followin following deta details exactly tly as they th the appear pp in your passport assport
YEAR YEA
DAY
MONTH NTH
YEAR
Make sure your p passport pa port is valid for the period perio of stay you are applying applyin for. Family nam name
Date
How long do you wish to stay in Aust Australia? a? Up t to 3 months nths Up p to 6 months month
Sex
Male e
DAY Y
Female
YEAR YEA
Up to 12 months
MONTH
Note: The stay s period pe d granted nted may be less l than th the period requested. requested reque You shou should che he terms of any visa granted. g ted. check the Do yo D you intend ntend to o enter Australia Austr on o more e than one occasion? occasion occa Go to Ques Question 7 Give details
Date of b birth
23-Aug-1989 23-Aug-19
Country C ntry of passport assport PHILIPPINES ES Nationality nality of passport holder pas as hold issue Date o of is
No N Yes
FILIPINO NO
DAY
MONTH
YEAR
DFA MANILA A A
Go to Question 7
ANILA MANILA
Specif the date Specify ate you ou wish to extend your stay to o exte ext
DAY
MONTH
YEAR Y
Provide ovid detailed tailed rea reasons for fo requesting equesting ting this further furt stay sta
PHILIPPINES PHI S
Separated Separat
Divorced Divorc
De facto cto
Widowed W wed
ca se s | lc ns ul na cy s t o a s c j | n s u l as es | j co nsu ltn ac y | sa m es | j lco ns ltn ac y | sa mp es | j lco ns ultn ac y | sa mp l u l n c | j o su ltn ac y | sa mp le l n c | j o su ltn ac y | sa mp le c lc ns l a y s m le c a on u tn cy | am p s c s a l l on su tn cy | am p e c as su ltn ac | sa p le as es m y c s a l l e e su tn c | a p | a s s m y c ltn ac | sa p le a es | j s m y c s a l ltn c | a p e a es | lc ac y | sa mp le ca se | jlco s s m y c s ac | a p le a e | jlco n y s m le c se s jlc n
10 1 0 Are you or have you been k known wn by any other o ot name? nam
No Yes
18 What at is your lega legal status in your current cu ent t location? locat
Citizen Visitor sitor Permanent resident Permane Perm Student
(including luding name at birth revious evious married names, nam aliases) ) birth, previous Give details G
Other
Note e: If this s visa application applicatio app is approved, roved, your current cu visa a ay cease. may
19 W What is the e purpose of yo your stay in your ur current location loca and what at is
ur vis atus? tus? your visa status?
1 2 Have 12 ve you applied applie for a Parent Pare (subclass ass 103) visa? visa
No Yes
DAY
MONTH ONTH
YEAR
13 Do y you c currently ently hold, old o or have e you applied d for, or, an APEC Business Bu Busine Travell
C (ABTC)? Card TC)? No N Yes
this visa is the Note: If thi sa application applica plic s approved, appro app he Australian visa associated with your ABTC will cease. as associa ABT w
Note te: A street address ad ired as a post t office o ddress dress cannot is required box address be accepted.
BLOCK LOC 4
SUBD. UB
BARANGAY B A Y RIZAL AL
POSTCODE POS
Country ountry
PHILIPPINES IPPINES
(If the ( e same sa as your ur residential address, add s, write rite AS ABOVE)
MANILA ILA
POSTCODE
Country Country
PHILIPPINES P IPP
16 6 D Do you hold old an n identity card or identity id ty number mber issued to t you by y your
gov nment nt (eg. National Nationa identity iden card) (if applicable applicable)? government Note because you ote: If you are the holder holde of f multiple iple identity numbers numb n are e a citizen of more m than n one e country, you need to enter r the identity number on the ca he country that you yo live ve in. card from the No Yes es Give details
AREA CO CODE
N NUMBER
) (
) )
Office
) (
+63 3
Family name F
23 D Do you agree to the department de departm nt communicating mmunicatin wi with you by e-mail eand/or nd/or fax fax?
This may inclu include re receiving ving notification of t the outcome ou ome of f this th application. icatio ication application Note: We W can communicate mmunicate nicate about this th app ation more quickly quic using u e-mail ma and/ ax ax. and/or fax. Give deta details
N o No
Y Yes
Country of f issue
@hotmail.com
AREA COD CODE
NUMBER ER
17 In what coun country are you currently countr rr locat located located?
PHILIPPINES PHIL
) (
ca se s | lc ns ul na cy s t o a s c j | n s u l as es | j co nsu ltn ac y | sa m es | j lco ns ltn ac y | sa mp es | j lco ns ultn ac y | sa mp l u l n c | j o su ltn ac y | sa mp le l n c | j o su ltn ac y | sa mp le c lc ns l a y s m le c a on u tn cy | am p s c s a l l on su tn cy | am p e c as su ltn ac | sa p le as es m y c s a l l e e su tn c | a p | a s s m y c ltn ac | sa p le a es | j s m y c s a l ltn c | a p e a es | lc ac y | sa mp le ca se | jlco s s m y c s ac | a p le a e | jlco n y s m le c se s jlc n
Part P art B Family Famil travelling travelling ellin to to Australia Au A ia with you yo
24 Are re you travelling to, to or are you ou currently in, in Au Australia with ith h any family members? m
No Yes Give ve details tails of each family fa member em ember Make ke sure all the appl app tions are lodged at the same time. me. e. applications Full name ame Relationship R to o you Name of f sponsor (if ( applicable) li ble) If insuffic insufficient uff space, space, give space g details etails s at Part O
Part C F Family Family NOT NOT travelling N travelling t ng to Australia Aus Australia with you
25 D Do you have ve a partner, any an children, dre or fianc nc who will NOT N be b travelling, ravelling, ling, or has NOT travelled, tra led, to Australia with wit you? yo
No Yes Give details
DAY DA
Y YEAR
Relationship to you
/ / / /
/ / / /
26 Is it likely lik yo you will be travelling from Australia Au alia a to any other country c (eg. g. New w Zealand, Singapore, Singapo Papua ua New Guinea) Guine and back Guinea ck k to Australia?
Attach itiner itinerary d details ails
DAY
YEAR
Address Add
/ / / /
/ / / /
Yes Ye Yes
ca se s | lc ns ul na cy s t o a s c j | n s u l as es | j co nsu ltn ac y | sa m es | j lco ns ltn ac y | sa mp es | j lco ns ultn ac y | sa mp l u l n c | j o su ltn ac y | sa mp le l n c | j o su ltn ac y | sa mp le c lc ns l a y s m le c a on u tn cy | am p s c s a l l on su tn cy | am p e c as su ltn ac | sa p le as es m y c s a l l e e su tn c | a p | a s s m y c ltn ac | sa p le a es | j s m y c s a l ltn c | a p e a es | lc ac y | sa mp le ca se | jlco s s m y c s ac | a p le a e | jlco n y s m le c se s jlc n
28 2 8 Do you have any friends frie or contacts ntacts ts in Au Australia? Aus a?
No Yes Give details ails Full name ame Date of birth
MONTH DAY YEAR Y
Address Addres
DENNIS S
/ 1981 98
FRIEND ND
SA 5086 50
MYLENE YLENE
1987 /
/ /
FRIEND FRIE
QLD LD 4115 11
No
Yes Yes
/ /
No No
Yes
Yes
Inc Include tails of any ny dates da that hat are ar of special a pecial ial significance significanc to your ur visit. t. details
I HEARD D A LOT OF STORIES S FROM FR MY FRIENDS FR ABOUT AUSTRALIA SPECIFICALLY ALL ADELAIDE AND ND BRISBANE. RISBANE. NOT NO ONLY THAT HA AUSTRALIA, USTR ACCORDING CCORDIN TO RECORD, ORD, IS ONE OF THE COUNTRIES UNTRIES HAS THE LOWEST RATE, WHICH H OWEST CRIME CR TE, IT OFFERS FERS A LOT OF ATTRACTIONS EDUCATIONAL, OT O IONS LIKE E ONA HISTORICAL GALLERY AND MUSEUM, HI M UM AND ND ART A GALLERY ASIDE GA IDE FROM ITS NATURAL AL FEATURES. URE I HAVE BEEN TIME, AND EN WORKING WORKIN FOR THE E LONGEST LONG A HAVE BEEN SAVING SAVIN UP MONEY NEY FOR A VERY V I WONDERFUL TRIP TR I HOPE I WOULD EXPERIENCE. EXP HAVE TO AVE ALWAYS ALWAY DREAMT T OF TRAVELING TRAVE AUSTRALIA, AND I KNOW AUSTRALIA OW THIS JOURNEY IS S WORTH WOR EVERY I DO HOPE AND PRAY VERY PENNY. P O EARNESTLY EARNEST APPROVAL THAT A AL BE GIVEN TO MY APPLICATION. LICATION.
ca se s | lc ns ul na cy s t o a s c j | n s u l as es | j co nsu ltn ac y | sa m es | j lco ns ltn ac y | sa mp es | j lco ns ultn ac y | sa mp l u l n c | j o su ltn ac y | sa mp le l n c | j o su ltn ac y | sa mp le c lc ns l a y s m le c a on u tn cy | am p s c s a l l on su tn cy | am p e c as su ltn ac | sa p le as es m y c s a l l e e su tn c | a p | a s s m y c ltn ac | sa p le a es | j s m y c s a l ltn c | a p e a es | lc ac y | sa mp le ca se | jlco s s m y c s ac | a p le a e | jlco n y s m le c se s jlc n
Part P rt E Health details d tails ls
35 During ring ing your propos proposed propo visit to o Australia, Austr a, do you expect Aus exp to incur ncur medical
require treatment or medical costs, sts, or requir req medic follow llow ow up u for: or: r: blood disorder; d cancer; ca can heart disease; se; ; hepatitis s B or C and/or and/o liver disease; se; HIV AIDS; V Infection, including inclu inc idney disease, diseas including dialysis; ialysis; kidney mental illness; illn ill pregnancy; preg sease ease that has required respiratory disease dmission or oxygen ox oxy y; hospital admission therapy; th other? No Yes Give details
31 In the last 5 years, ha have h you visited or lived outside out your country of
passport for more than an 3 consecutive months? month Do not iinclud Australia. include time spent in Austr No Yes Give details
1. . Country(s) Country(s
DAY
MONTH
YEAR
DAY AY
MONTH
YEAR
Date D
from
to
DAY
YEAR YEA
DAY
MONTH
YEAR Y
Date
from f
to o
3 C 3. Country(s) ntry(s) )
DAY
MONTH TH
YEAR
DAY
MONTH NTH
YEAR
Date
from
t to
32 Do yo you intend ntend d to enter a hospital hospita ho or health lth care facility fac (including ng
nursing n ng g homes) while in Australia? Aus ia? No Yes s Give de details s
Give details
37 Have 3 e yo you undertaken ndertaken dertaken a healt health examination xamination ation for an Austra A Australian n visa a in
ast 12 1 months? nths? ths? the last No o Yes
33 Do you inte intend to work rk as, or study to be, b a doctor, d or, dentist, entist, nurse or o
parame g your ur stay in Australia? Austr paramedic du during No Yes Give ive details
Give details eta (including ncluding cluding HAP H ID if available) vailable) le)