VISA REGISTRATION & PERSONAL PARTICULARS FORM

STAFF-IN-CONFIDENCE (when completed)

AUSTRALIAN HIGH COMMISSION VISA OFFICE

REGISTRATION & PERSONAL PARTICULARS FORM

Note: all fields must be complete. If a question is not applicable, write N/A. Incomplete applications will render an application invalid.

PARTICULARS OF POSITION APPLIED FOR
Position applied for
PERSONAL PARTICULARS
Title	eg Mr, Mrs, Miss, Ms, Dr
Surname
Given names
Other names you are or have been known by
Of which countries are you a citizen?	Include details of date of citizenship if applicable
Date & place of birth

EMPLOYMENT (continued)	If you answer yes to any of these questions, provide full details including occupation/designation and period of employment.
Are you currently employed by, or have you previously been employed by another Embassy or High Commission?
Have you ever been employed by the Indian government or military?
Have you ever been disciplined for misconduct at any employment?
List employment experience on a separate page	Include contact details of employer, occupation, period of employment and reason for leaving
OVERSEAS TRAVEL	If yes to any of these questions, include full details of passport number, place of issue, date of expiry, details of previous passports held, countries visited, countries of residence, dates of visits, dates of residence
Details of your passport
Have you ever visited overseas?

SUPERVISORS
Current supervisor’s name
Contact number
Duration of relationship
Immediate previous supervisor’s name
Contact number
Duration of relationship
WRITTEN REFERENCES (if provided)
Referee’s name
Contact number
Referee’s name
Contact number

EDUCATION
Qualification/s
Institution/s & year attained
LANGUAGES
Provide details of languages spoken and proficiency levels (basic, intermediate, advanced)
Have you undertaken IELTS exam? If yes, attach results.
HEALTH AND CHARACTER	If you answer yes to any of these questions, provide full details on a separate page.
Why do you want to work at the Australian High Commission Visa Office?
Have you ever been convicted of a crime or offence in any country?
Have you ever been charged with any offence that is currently awaiting legal action?
Have you ever been acquitted of any criminal offence?
Have you been involved in any activities that would represent a risk to Australian national security or the reputation of the Australian government?
Have you ever been involved in any activity relating to illegal movement of people to any country?
Are there any other factors in relation to your health and character which you feel would affect your ability to work at the Australian High Commission Visa Office?

Applicant’s Statement

The above information, to the best of my knowledge, is true and correct. I consent to the Australian High Commission collecting and using information, and to relevant employers disclosing information, in relation to my work performance and conduct for the purpose of assessing my suitability to carry out the duties of the job I have applied for, and suitability to become an employee at the Australian High Commission Visa Office. WARNING: Giving false or misleading information is a serious offence.

Values Statement

The Department of Immigration and Citizenship is committed to maintaining the integrity of its staff in its endeavour to deliver excellent services within its visa and citizenship programs. Officers representing the Department must uphold the highest levels of personal integrity and professionalism in all areas of their life. By signing below, you undertake that you are of good character, have provided honest answers, and will display and uphold integrity, professionalism and act ethically in the course of your duties.

____________________________ ____________________________
Signature and date Name (in block letters)

Staff-in-confidence (when completed)