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, 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 | |
| Residential address | |
| Postal address | If postal address is the same as residential address, write ‘as above’ |
| Home phone number | |
| Mobile number | |
| Alternative contact number | |
| Email address | |
| Marital status | If married, provided date of marriage |
| Details of family composition | Include names and dates of birth of all family members in your household |
| EMPLOYMENT | If you answer yes to any of these questions, provide full details including occupation/designation and period of employment. |
| Current employment | |
| Are you currently employed by, or have you previously been employed by the Australian High Commission? | |
Are any of your family members (including extended family) employed by the Australian High Commission in any capacity? This includes domestic workers. |
|
| Are you currently employed by, or have you previously been employed by another Embassy or High Commission? | |
| Are any of your family members (including extended family) employed by another Embassy or High Commission or Government of India in any capacity? This includes domestic workers. | |
| Have you or any of your family members (including extended family) ever been employed by a migration agent, education agent or travel agency in any capacity? | |
| 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? | |
| 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 |
| If married, has your spouse ever visited overseas? | |
| Do you have any relatives residing overseas? | |
| Do you have any friends or relatives who live in Australia? |
| 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 an 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? | |
| Do you know of any threatened legal action against you for any act or omission by you | |
| Have you ever been acquitted of any criminal offence? | |
| Have you ever 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, goods, arms, drugs or any illegal or prohibited substance to any city in India or to any country? | |
| Are there any medical issues which may affect your ability to work in an office for eight hours per day, five days per week, with occasional overtime? | |
| Are there any factors in relation to your health or other factors in relation to your character which you feel would affect your ability to work at the Australian High Commission Visa Office? | |
| Is there any other matter you would like us to be aware of which you feel is material and should be informed to us with regard to your application?* |
• Concealment of material information is a serious offence and amounts to a knowing and deliberate misrepresentation.
Applicant’s Statement
The above information, to the best of my knowledge, is true and correct and I have not concealed any material information there from. 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 or making a misrepresentation 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)