1. Full Name:           
2. Marital Status:     
3. Date and place of birth (town, province/state and country):
4. Citizenship of any country apart from country of birth:       
    (if applicable)

5. Details of any visa applications for travel to Australia made by the applicant or anyone included in the application:
- date of application:        
- place of application:      
- type of visa applied for:  
- result of application (granted, refused, withdrawn):

6. Current Address:

Street    
Suburb   City State / County
Country   Postcode

7. Current postal address (if different from home address):

Street    
Suburb   City State / County
Country   Postcode

8. Current home and work telephone numbers 

Home:    
Work:     

09. Facsimile number:            
 
10. Email address            



11. Details of qualifications held

	Qualifications 1	Qualifications 2	Qualifications 3	Qualifications 4
- name of qualification
- name of institution
- date of completion
- language of instruction
- length of course (years)

	Employer 1	Employer 2	Employer 3	Employer 4
- names and addresses of employers
- type of business
- your occupation
- dates of beginning and ending

do not have any

13. Details of business enterprises in the last five years:

	Business 1	Business 2	Business 3	Business 4
- names and addresses of business
- your ownership interest (percentage),
- number of employees
- period of operation

14. Value of assets available for transfer to Australia for investment in the proposed business (must be at least $250,000);



15. Type of assets:

- cash on deposit
- shares/stocks/bonds
- property
- jewelry/bullion

others(specify)

16. Whether the applicant or any person included in the application has suffered a serious illness or medical condition or has been convicted of a criminal offence (if so, details);

no      yes    

 if yes fill in details:


17. Information relating to the proposed business

1. Number of staff expected to be employed by the business   

2. A brief description of the proposed business (location, what it will do);



3. An estimate of the costs involved in setting up the business

4. Details of any investigation done so far towards setting up the business (visits to Australia, contacts in Australia etc).