ELIGIBILITY QUESTIONNAIRE

Fill out the Australian Eligibility Assessment Questionnaire below - a processing fee applies.

IMMagine Australia Eligibility Questionnaire

Step 1 of 5

This is not an official Government form but has been designed by us to gather all the information required to assess your eligibility to meet your immigration objective. All information received through this form will be treated in the strictest confidence and will not be passed on to any third party without your express permission.

Assessment Report

How would you like to receive your assessment?

Personal Details - Principal Applicant

Last name

Given names

Male or female?

Date of birth

Country of birth

List all citizenships

Home phone number include country and area code


Country	Area	Home phone number

Work phone number including country and area code


Country	Area	Work phone number

Mobile number including country code

Email address

Marital status

How long have you lived together

Have you ever been divorced?

If divorced, please state when

Postal and Physical Addresses

Personal Details - Spouse / Partner

Last name

Given names

Male or female?

Date of birth

Country of birth

List all citizenships

Home phone number include country and area code


Country	Area	Home phone number

Work phone number including country and area code


Country	Area	Home phone number

Mobile number

Email address

Has your partner ever been divorced?

If divorced, please state when

Children (Including all children from previous relationships)

Child 1

Name		Date of birth
Male/Female		Country of residence
Do you have full custody?	Yes	Country of citizenship

Child 2

Name		Date of birth
Male/Female		Country of residence
Do you have full custody?	Yes	Country of citizenship

Child 3

Name		Date of birth
Male/Female		Country of residence
Do you have full custody?	Yes	Country of citizenship

Child 4

Name		Date of birth
Male/Female		Country of residence
Do you have full custody?	Yes	Country of citizenship

Spouse/Partner children details if different from above

Health

Do you or any person included in this application have any current medical condition that requires regular medication, monitoring or care by your GP or Specialist? If yes, please provide details of the condition, date of diagnosis, any treatment and current prognosis
Yes

Details

Do you or any person associated with this application have any intellectual or learning disabilities?
Yes

Details

If you have any additional information that you would like to add, please use the box below.

Step 1 additional notes

In order for IMMagine Australia to fully assess your eligibility against all current immigration criteria we need you to complete as much of the information below as possible. The cost for the assessment is AUD$150.00 which you can pay by Credit Card (Mastercard or Visa) via our online payment system at the end of the questionnaire.

Eligibility Questionnaire

Download the form above by right clicking and choosing 'save as' if you'd rather email it back to us later (you can add data to the PDF) via email.

Who is IMMagine?

With a residence success rate higher than 99% and more than 20 years of experience, you are in the right place if you're looking to live and work in Australia. We have a team of experience, licensed advisor's available to assist you with your move. Read more...

Immigration Seminars

If you want to learn more about Australia as a migration destination, Australian immigration policy and process, see if we have seminars planned for your city. Our seminars are held regularly in South Africa and South East Asia. Read more...

Work in Australia

We receive literally hundreds of emails every month from prospective migrants who need a job in order to get into Australia (or simply to eat once they are here) asking us whether we can help them to get the job or how they should go about doing it. Read more...