Visa Application
Visa Application
Personal Privacy
Current location
Give details of the applicant's current location.
Current location: INDIA
Legal status: Citizen
Application type
Is this the first time the applicant is applying for a student visa?
Yes
Is the applicant applying for this visa because their study in Australia has been deferred due to
COVID-19?
No
Confirmation of enrolment
Does the applicant hold a Confirmation of Enrolment (CoE) for any intended course of study in
Australia?
Yes
Does the applicant hold evidence of their intended study in Australia other than a CoE?
No
Note: Do not add a Letter of offer for a course that has already been included in the Confirmation of
enrolment section above. Adding a CoE and a Letter of offer for the same course is unnecessary and
may lead to delays in processing the application.
Personal Privacy
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Application for a Student Visa
Education sector
Select the education sector of the applicant's principal course.
Education sector: Higher Education Sector
Closure of education provider
Is the applicant applying for this visa due to the closure of their Australian education provider?
No
Commonwealth funded student
Is the applicant receiving partial or full funding under a training scheme approved by the
Commonwealth government of Australia?
No
Primary applicant
Information: Entering names incorrectly may result in denial of permission to board an aircraft to
Australia, or result in delays in border processing on arrival to Australia, even if the applicant has
been granted a visa.
Passport details
Enter the following details as they appear in the applicant's personal passport.
Family name: Viney
Given names:
Sex: Male
Date of birth: 15 Jun 1996
Passport number: R7069690
Country of passport: INDIA - IND
Nationality of passport holder: INDIA - IND
Date of issue: 03 Nov 2017
Date of expiry: 02 Nov 2027
Place of issue / issuing Passport Office Chandigarh
authority:
It is strongly recommended that the passport be valid for at least six months.
National identity card
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Application for a Student Visa
Given names:
Identification number: 711910591972
Country of issue: INDIA
Note: If the National identity card does not have a Date of issue or a Date of expiry, do not enter a
date. Leave the field/s blank.
Date of issue:
Date of expiry:
Place of birth
Is this applicant currently, or have they ever been known by any other names?
No
Citizenship
Has this applicant undertaken a health examination for an Australian visa in the last 12 months?
Yes
Give details: HAP ID 36970155
HAP ID (If available) 36970155
Critical data confirmation
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Application for a Student Visa
Is this family member currently, or have they ever been known by any other names?
No
Citizenship
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Health examination
Has this applicant undertaken a health examination for an Australian visa in the last 12 months?
Yes
Give details: HAP ID 36970156
HAP ID (If available) 36970156
Child custody details
Country of residence
Personal Privacy
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Application for a Student Visa
Email address:
Authorised recipient
Does the applicant authorise another person to receive written correspondence on their behalf?
This authorises the department to send the authorised person all written correspondence that would
otherwise be sent directly to the applicant.
Yes, an education agent
This person is referred to as the 'authorised recipient'.
Education agent contact details
Education agent
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Application for a Student Visa
Country: INDIA
Address: A-8, Rajouri Garden,
Suburb / Town: New Delhi
State or Province: DELHI
Postal code: 110027
Contact telephone numbers
Enter numbers only with no spaces.
Business phone: 9101141752288
Mobile / Cell phone: 919871150445
Electronic communication
The Department prefers to communicate electronically as this provides a faster method of
communication.
All correspondence, including notification of the outcome of the application will be sent to:
Email address: [email protected]
Note: The holder of this email address may receive a verification email from the Department if the
address has not already been verified. If the address holder receives a verification email, they should
click on the link to verify their address before this application is submitted.
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Application for a Student Visa
Was the Overseas Student Health Cover (OSHC) organised by the applicant's education provider?
Yes
Name of health insurer: Medibank Private
Insurance policy number:
Date from: 21 Jun 2024
Date to: 15 Sep 2026
Family member health insurance
Are all accompanying family members covered by the same health insurance as the applicant?
Yes
Education
Has the applicant completed, or is currently enrolled in any other studies or training outside
Australia?
Yes
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Application for a Student Visa
Employment history
Give details of the applicant's employment and unemployment history since leaving school/college/
university.
• Employment includes all paid employment, self-employment, family business employment, work
experience, internships, unpaid employment and volunteer work. • Unemployment includes all gaps
in employment since leaving school/college/university.
Employment history details
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Application for a Student Visa
Has the applicant been offered a job at the completion of their course?
No
Give details of the type of employment the applicant will be seeking at the completion of their course:
Statement of Purpose Attached
Language
Language ability
Has the applicant undertaken an English language test within the last 24 months?
Yes
English test details
Give details of the highest scoring English test over the 24 month period.
Name of test: PTE Academic
Date of test: 16 Oct 2023
Test reference number: PTE002889036
Country where test was INDIA
undertaken:
Overall test score: 71
Main language
Has the applicant successfully completed at least five years study (in the English language) in
Australia, Canada, New Zealand, Republic of South Africa, Republic of Ireland, United Kingdom and/
or United States of America?
No
In the two years before applying for the Student visa, has the applicant successfully completed the
requirements for a Senior Secondary Certificate of Education (conducted in English in Australia)?
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Application for a Student Visa
No
In the two years before applying for the Student visa, has the applicant successfully completed
a substantial component of a course leading to a qualification from the Australian Qualifications
Framework at Certificate IV or higher as a holder of a Student visa (conducted in English in
Australia)?
No
Language - KADYAN, SWATI (28 Apr 1996)
Main language
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Application for a Student Visa
Does any applicant intend to work, study or train within aged care or disability care while in Australia?
No
Does any applicant intend to work or be a trainee at a child care centre (including preschools and
creches) while in Australia?
No
Has any applicant:
• ever had, or currently have, tuberculosis?
• been in close contact with a family member that has active tuberculosis?
• ever had a chest x-ray which showed an abnormality?
No
During their proposed visit to Australia, does any applicant expect to incur medical costs, or require
treatment or medical follow up for:
• blood disorder
• cancer
• heart disease
• hepatitis B or C and/or liver disease
• HIV infection, including AIDS
• kidney disease, including dialysis
• mental illness
• pregnancy
• respiratory disease that has required hospital admission or oxygen therapy
• other?
No
Does any applicant require assistance with mobility or care due to a medical condition?
No
Character declarations
If the applicant answers ‘Yes’ to any of the character declarations they must give all relevant details.
For combined applications, state which applicant the declaration applies to.
If the matter relates to a criminal conviction, provide:
• the date and nature of the offence
• full details of the sentence
• dates of any period of imprisonment or other detention.
Has any applicant ever been charged with any offence that is currently awaiting legal action?
No
Has any applicant ever been convicted of an offence in any country (including any conviction which is
now removed from official records)?
No
Has any applicant ever been the subject of a domestic violence or family violence order, or any other
order, of a tribunal or court or other similar authority, for the personal protection of another person?
No
Has any applicant ever been the subject of an arrest warrant or Interpol notice?
No
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Application for a Student Visa
Has any applicant ever been found guilty of a sexually based offence involving a child (including
where no conviction was recorded)?
No
Has any applicant ever been named on a sex offender register?
No
Has any applicant ever been acquitted of any offence on the grounds of unsoundness of mind or
insanity?
No
Has any applicant ever been found by a court not fit to plead?
No
Has any applicant ever been directly or indirectly involved in, or associated with, activities which
would represent a risk to national security in Australia or any other country?
No
Has any applicant ever been charged with, or indicted for: genocide, war crimes, crimes against
humanity, torture, slavery, or any other crime that is otherwise of a serious international concern?
No
Has any applicant ever been associated with a person, group or organisation that has been or is
involved in criminal conduct?
No
Has any applicant ever been associated with an organisation engaged in violence or engaged in
acts of violence (including war, insurgency, freedom fighting, terrorism, protest) either overseas or in
Australia?
No
Has any applicant ever served in a military force, police force, state sponsored / private militia or
intelligence agency (including secret police)?
No
Has any applicant ever undergone any military/paramilitary training, been trained in weapons/
explosives or in the manufacture of chemical/biological products?
No
Has any applicant ever been involved in people smuggling or people trafficking offences?
No
Has any applicant ever been removed, deported or excluded from any country (including Australia)?
No
Has any applicant ever overstayed a visa in any country (including Australia)?
No
Has any applicant ever had any outstanding debts to the Australian Government or any public
authority in Australia?
No
Student declarations
Warning:
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Application for a Student Visa
government (as the case requires) does not oppose them undertaking a relevant course of study,
and that they will be required to depart Australia on or before the authorised date.
Yes
Declarations
Warning:
Giving false or misleading information is a serious offence.
The applicants declare that they:
Have read and understood the information provided to them in this application.
Yes
Have provided complete and correct information in every detail on this form, and on any attachments
to it.
Yes
Understand that if any fraudulent documents or false or misleading information has been provided
with this application, or if any of the applicants fail to satisfy the Minister of their identity, the
application may be refused and the applicant(s), and any member of their family unit, may become
unable to be granted a visa for a specified period of time.
Yes
Understand that if documents are found to be fraudulent or information to be incorrect after the grant
of a visa, the visa may subsequently be cancelled.
Yes
Understand that if this application is approved, any person not included in this application will not
have automatic right of entry to Australia.
Yes
Will immediately notify the Department in writing about any changes to their email or residential
address, course enrolment, or members of their family unit, or changes to any information they
provided in their application, while this application is being considered.
Yes
Have read the information contained in the Privacy Notice(Form 1442i).
Yes
Understand that the department may collect, use and disclose the applicant's personal information
(including biometric information and other sensitive information) as outlined in the Privacy
Notice(Form 1442i).
Yes
Give consent to the collection of their fingerprints and facial image if required.
Yes
Understand that, if required to provide their fingerprints and facial image, the applicant's fingerprints
and facial image and biographical information held by the Department may be given to Australian law
enforcement agencies to help identify the applicant and determine eligibility for grant of the visa being
applied for, and for law enforcement purposes.
Yes
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Application for a Student Visa
Give consent to Australian law enforcement agencies disclosing the applicant's biometric,
biographical and criminal record information to the Department to help identify the applicant, to
determine eligibility for grant of a visa and for law enforcement purposes.
Yes
Give consent to the Department using the applicant's biometric, biographical and criminal record
information obtained for the purposes of the Migration Act 1958 or the Citizenship Act 2007.
Yes
As an applicant:
I understand that if my visa ceases to be in effect and I do not hold another visa to remain in Australia
at that time, I will be an unlawful non-citizen under the Migration Act 1958. As such, I will be expected
to depart from Australia, and be subject to removal under the Migration Act 1958.
Yes
Australian values
Each applicant who is 18 years or over has read, or had explained to them, information provided by
the Australian Government on Australian society and values, and agrees to the Australian values
statement.
Yes
Life in Australia booklet Australian values statement
Personal Privacy
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