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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 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
Date of expiry
1 Your family name in English
Issuing authority/place of issue as shown in your passport
Family name
Given names
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
Mobile/cell
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
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
5. Name in English
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