PERSONAL PARTICULARS Name of Principal Applicant: (Please state title - Mr., Mrs., Miss, Ms., Dr.) Surname: Correspondence address: Tel.: Fax: Home address (if different from above): Tel.: Fax: Date of birth: Citizenship (if more then one state All): Occupation: Marital Status: Single Married Divorced Widowed Defacto with partner Passport (state country): No. of years in this occupation:   ACADEMIC QUALIFICATIONS Name of Institution Qualification Length of Study Involved Year passed     OTHER TRAINING COURSES (Current and Completed in last 6 years) Course Institution Length of Course Certificate Awarded     LANGUAGE  (Please indicate language proficiency below * , eg Very Good, Good, Average, Below Average)   Language Listening Speaking Writing Knowledge of English * * * First Language * * * Other * * *     SPOUSE OR DEFACTO PARTNER  Please state the number of years with Spouse/Partner: Years Name Years Together Occupation Age Nationality Language Highest Qualification     CHILDREN Name Age Dependent or Independent Citizenship Country of Residence Highest Qualification     RELATIVES LIVING IN AUSTRALIA Name Relationship Status in Australia (e.g. Aust. Citizen etc.) State (Area)     PERSONAL ASSETS   Total Assets (A$) Any Amount Invested in a Business to-date (A$) Amount of Liquid Assets (A$) Amount able to be transferred for Business (A$) Self: Spouse:     WORK EXPERIENCE  Please also indicate if any future employment arrangements have been made or are likely to be arranged. Name of Organization Position Country Location Period in Position (Dates) Annual Salary (A$) Nature of Employment   MEMBERSHIP OF PROFESSIONAL BODIES Name of Professional Body Category of Membership Period of Memebership   BUSINESS OWNERSHIP Position Occupied Period (Dates) Paid-Up Capital (A$) Annual Turnover (A$) (past 2 yrs) Nature of Business No. of Employees Total Annual Labor Costs A$ (past 2 yrs) Total Assets (A$) Position Occupied Period (Dates) Paid-Up Capital (A$) Annual Turnover (A$) (past 2 yrs) Nature of Business No. of Employees Total Annual Labor Costs A$ (past 2 yrs) Total Assets (A$) Position Occupied Period (Dates) Paid-Up Capital (A$) Annual Turnover (A$) (past 2 yrs) Nature of Business No. of Employees Total Annual Labor Costs A$ (past 2 yrs) Total Assets (A$) Position Occupied Period (Dates) Paid-Up Capital (A$) Annual Turnover (A$) (past 2 yrs) Nature of Business No. of Employees Total Annual Labor Costs A$ (past 2 yrs) Total Assets (A$) Position Occupied Period (Dates) Paid-Up Capital (A$) Annual Turnover (A$) (past 2 yrs) Nature of Business No. of Employees Total Annual Labor Costs A$ (past 2 yrs) Total Assets (A$) Position Occupied Period (Dates) Paid-Up Capital (A$) Annual Turnover (A$) (past 2 yrs) Nature of Business No. of Employees Total Annual Labor Costs A$ (past 2 yrs) Total Assets (A$)     DO YOU INTEND TO START A BUSINESS IN AUSTRALIA? Yes No If 'Yes', State   Amount of Investment (A$) Proposed No. of Employees Proposed Location of New Business   ANY FURTHER COMMENTS Please type in the number displayed above*: (This is a security measure preventing automated submissions of this form) Top Copyright © 2008 www.successimmi.com All Rights Reserved Site by Smokybyte