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Migration Assessment

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Australian Migration Assessment Form

Date
Section A: Your Personal Details
Title
Full Name (as per passport)
Surname Given Names
Previous Name (if applicable)
Surname Given Names
Sex
- Male
- Female
Date of Birth
Birth Place
City Country
Passport No
Passport Issue Date
Passport Expiry Date
Nationality
Passport Issuing Authority
Current Visa Type (If applicable)
Current Visa Expiry Date (If applicable)
Contact Details
Email Address
Australian Phone Number
Address in Australia
Overseas Phone Number
Overseas Address
Alternative Contact Person
Name
Name
Contact No.
English Language Ability
Test Type
Listening Reading Writing Speaking
Overall Result
Test Date
Relationship Status
- Never Married
- Married
- Engaged
- De Facto
- Separated
- Divorced
If you have a partner/spouse and/or children, please provide details below:
Full Name Date of Birth Nationality English Language Ability
Section B
Academic Qualifications (Start from High School to Current):
Name of Qualification Start Date (dd/mm/yy) Completion Date (dd/mm/yy) School/ Institute Country
Employment Experience (Start from the First Employment to Current)
Position Company Name Start Date (dd/mm/yy) End Date (dd/mm/yy) Duties Annual Income
Section C
Personal Assets
Assets Type (e.g.: Property) Details Total Value

Please provide the approximate total of all your fixed and liquid assets:
Business Assets
Company Name Nature of Busines Date of Establishment (dd/mm/yy) % of Ownership Last 4 years Annual Turnover Net Assets

*If you are an owner, shareholder or director of the business, please state your % of ownership, and approximate last 4 years annual turnover.
Which State do you prefer to migrate? (Please tick all that are appropriate)
- SA
- NSW
- VIC
- QLD
- WA
- TAS
- NT
- ACT
Do you have any close relatives in Australia?
- Yes
- No
If yes, please provide the details
Full Name
Relationship
Address
Have you ever had a visa for Australia or any other country refused or cancelled?
- Yes
- No
Please provide details
Do you have any previous criminal convictions?
- Yes
- No
Please provide details
Do you have any health issues?
- Yes
- No
Please provide details
CRM Contact ID

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Adelaide SA 5000 AUSTRALIA

Postal Address

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Adelaide BC SA 5000 AUSTRALIA

Phone:

+61 8 8410 4984

Fax:

+61 8 8212 7276

Email

info@centuryocean.com.au
edu@centuryocean.com.au

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