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Form

Nomination of student dependants 919


Department of Home Affairs

About this form Integrity of nomination


Important – Please read this information carefully before you The Department is committed to maintaining the integrity of the
complete this nomination. Once you have completed this visa and citizenship programmes. Please be aware that if you
nomination we strongly advise that you keep a copy for your provide us with fraudulent documents or claims, this may result
records. in processing delays and possibly your nomination being refused.
This form is to be used by Student (Temporary) (Class TU) visa
holders in Australia who wish to nominate eligible family Important information about privacy
members to join them in Australia. It is to be used where the Your personal information is protected by law, including the
eligible family members are applying separately from the student Privacy Act 1988. Important information about the collection,
visa holder outside Australia. use and disclosure (to other agencies and third parties, including
Under the migration legislation, a person is an eligible family overseas entities) of your personal information, including
member of a Student (Temporary) (Class TU) visa holder if the sensitive information, is contained in form 1442i Privacy notice.
person is: Form 1442i is available from the Department’s website
• a partner (including spouse or de facto partner) of the student www.homeaffairs.gov.au/allforms/ or offices of the
visa holder; or Department. You should ensure that you read and understand
form 1442i before completing this form.
• a dependent child of the student visa holder, or of that
partner, who is unmarried and has not turned 18.
Foreign Affairs or Defence sponsored students should contact
the Department of Foreign Affairs and Trade or the Department Home page www.homeaffairs.gov.au
of Defence for procedures. It is not necessary for you to General Telephone 131 881 during business hours
complete this form. enquiry line in Australia to speak to an operator (recorded
information available outside these hours).
How to nominate If you are outside Australia, please contact
Complete this form and send it, along with the documents your nearest Australian mission.
required, to your dependant(s) overseas.
Your dependant(s) should complete form 157A Application for a
student visa online and attach this form 919 Nomination of
student dependants.

Documents
Your family members who want to join you in Australia will need
to provide required documents with their application.
For detailed information, refer to the Department’s website
www.homeaffairs.gov.au/trav/visa-1/500-?modal=/trav/stud/brin

Please keep this information page for your reference


© COMMONWEALTH OF AUSTRALIA, 2018 919 (Design date 02/18) - Page 1
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Form

Nomination of student dependants 919


Department of Home Affairs

Please open this form using Adobe Acrobat Reader. 8 Details from your passport
Either type (in English) in the fields provided or print this form
Passport number
and complete it (in English) using a pen and BLOCK LETTERS.
Tick where applicable 3 Country of passport
Day Month Year

Part A – Your details Date of issue

Date of expiry
1 Your family name in English
Issuing authority/place of issue as shown in your passport
Family name

Given names

2 Sex Male Female


9 Details of identity card or identity number issued to you by your
Day Month Year government (if applicable) eg. National identity card.
3 Date of birth Note: If you are the holder of multiple identity numbers because you are
a citizen of more than one country, you need to enter the identity
4 Place of birth number on the card from the country that you live in.

Town/city Identity number

Country Country of issue

5 Citizenship/ 10 Have you changed your address and/or contact number since you were
Nationality granted your current student visa?
No Go to Question 15
6 Relationship status
Day Month Year Yes
Married Date of marriage
Engaged Date of intended 11 Your current residential address
marriage (if applicable) Note: A post office box address is not acceptable as a residential address.
De facto Date cohabitation began
Separated
Divorced
Postcode
Widowed
Never married or
been in a de facto 12 Address for correspondence
relationship (If the same as your residential address, write ‘AS ABOVE’)
Note: It is your responsibility to advise the Department of any change to
7 Your immigration file number (if known) your address for correspondence during the application process.
Overseas

In Australia
Postcode

13 Contact telephone numbers


Office hours (Area code )

After hours (Area code )

Mobile/cell

© COMMONWEALTH OF AUSTRALIA, 2018 919 (Design date 02/18) - Page 3


14 Do you agree to the Department communicating with you by electronic 20 Have you obtained health insurance for your dependants for the duration
means? of your intended stay on a student visa?
No No
Yes Give details Yes Please provide evidence
Fax number (Area code ) For more information, refer to www.homeaffairs.gov.au/
trav/stud/more/health-insurance-for-students
Mobile/cell

Email address Eligible family members


coming to Australia
15 Give details of the Australian visa that you currently hold
Visa label number 21 Give details of eligible family members who will be joining you in
Australia while you hold a student visa.
V <
(Eligible family members may include your partner and any dependent
If you were granted a visa without a label, give the 13-digit visa grant children of you or your partner who are unmarried and have not turned 18.)
number (as shown on the letter that notified you of visa grant).
1. Name in English

Office of visa issue Ethnic script


Relationship
to you
Day Month Year Day Month Year
Date of issue Date of birth

16 Give details of the course that you are currently studying Place of birth
Name of your current course Citizenship/
Nationality
Is evidence of your relationship attached? Yes No
Name of the education provider or training body
2. Name in English

Day Month Year Day Month Year Ethnic script


Course duration to Relationship
to you
Day Month Year
17 Do you currently have any other visa applications being assessed by the
Date of birth
Department in Australia or overseas?
No Place of birth
Yes Give details Citizenship/
Type of application Nationality
Is evidence of your relationship attached? Yes No

When did you lodge this application? 3. Name in English

Ethnic script
Where did you lodge this application? Relationship
to you
Day Month Year

Date of birth
18 Do you have adequate means to support yourself and your dependants?
No Place of birth
Yes You may be asked to provide supporting documents Citizenship/
Nationality
19 Have you enrolled any school aged dependants (that is, children who are Is evidence of your relationship attached? Yes No
unmarried and who have turned 5 years of age, but have not yet turned 18
years of age) who are included in this nomination, in a school in Australia?
No
Yes Please provide evidence of enrolment, including details of
any school fees

919 (Design date 02/18) - Page 4 © COMMONWEALTH OF AUSTRALIA, 2018


4. Name in English Assistance with this form
Ethnic script 24 Did you receive assistance in completing this form?
Relationship No Go to Question 28
to you
Day Month Year
Yes Please give details of the person who assisted you

Date of birth Title: Mr Mrs Miss Ms Other

Place of birth Family name


Citizenship/
Nationality Given names
Is evidence of your relationship attached? Yes No Address

5. Name in English

Ethnic script Postcode


Relationship
to you Telephone number or daytime contact
Day Month Year Country code Area code Number

Date of birth Office hours ( ) ( )

Place of birth Mobile/cell


Citizenship/
Nationality 25 Is the person an agent registered with the Migration Agents Registration
Is evidence of your relationship attached? Yes No Authority (MARA)?
No
If insufficient space, please attach a separate sheet
Yes Go to Question 28
22 Overseas contact address of eligible family members who will be joining
you in Australia 26 Is the person/agent in Australia?
In English No Go to Question 28
Yes

27 Did you pay the person/agent and/or give a gift for this assistance?
Postcode No
Yes
Ethnic script

Declaration
Postcode
WARNING: Giving false or misleading information is a serious offence.
28 I declare that:
23 Overseas contact telephone numbers of eligible family members who
• the information supplied on and with this nomination form is
will be joining you in Australia
complete, true and correct in every particular.
Country code Area code Number
• I have read the information contained in form 1442i Privacy notice.
Office hours ( ) ( )
• I understand the Department may collect, use and disclose my
After hours ( ) ( ) personal information (including biometric information and other
sensitive information) as outlined in form 1442i Privacy notice.
Personal/private
mobile/cell
Your
signature
-
Day Month Year

Date

We strongly advise that you keep a copy of this nomination


and all attachments for your records.

© COMMONWEALTH OF AUSTRALIA, 2018 919 (Design date 02/18) - Page 5

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