Application for Northern Territory Government Skilled Nominated (Subclass 190) visa and Skilled Regional (Subclass 489) visa Subclass 190 and 489 Nomination Application Form (Please complete this form by type or block letters) Please tick the box corresponding to the appropriate visa number below and answer all questions in order for Migration NT to determine your eligibility for nomination 190
489
1. Northern Territory Nomination Eligibility As a Northern Territory (NT) Skilled Nominated (SN) or Skilled Regional Nominated (SRN) visa holder you and your family can live anywhere in the NT. 1.1 Eligibility for Northern Territory Government Nomination Is your occupation on the NT Migration Occupation List? A link to the NT skill shortage list can be found at http://www.australiasnorthernterritory.com.au/Working/bsm/nt-nominatedgeneral/Pages/sol.aspx
Yes
No
Have you received an offer of employment in the NT?
Yes
No
Are you currently working in your nominated skilled occupation in the NT?
Yes
No
Are you able to provide strong evidence of employability in the NT in your nominated occupation?
Yes
No
Do you or your spouse have family links in the NT?
Yes
No
Yes
No
Yes
No
If so, for how long?
Have you completed tertiary studies on a Charles Darwin University campus? (If yes, please attach evidence)
What are your reasons for applying for NT nomination? Please detail.
1.2 Education (only complete this section if you have studied in Australia) Have you ever studied in Australia? (If yes, please provide details below)
Name of institution Location of campus
Course undertaken
Award received
Date completed
Duration of course / degree (State in terms of full-time or equivalent full-time study)
Department of Business
Skilled Nominated (Subclass 190) visa and Skilled Regional (Subclass 489) visa Subclass Subclass 190 and 489 Nomination Application Form 1.3 Australian skill assessment Have you completed an Australian skills assessment?
Yes
(If yes, please complete the following details)
No
Name of assessing body (Attach a copy of your assessment from the relevant Australian Assessment Authority)
Date of assessment What is the title of your nominated occupation? What is the ANZSCO Code for your nominated occupation? Refer to the Department of Immigration and Border Protection “Consolidated Skilled Occupation List” available online at http://www.border.gov.au/Trav/Work/Work/Skills-assessment-and-assessingauthorities/skilled-occupations-lists/CSOL
2. Department of Immigration and Border Protection (DIBP) information 2.1 Visa information Have you lodged an Expression of Interest (EOI) in SkillSelect?
Yes
http://www.border.gov.au/Trav/Work/Skil
No
If yes, what is the name / subclass of the visa applied for? If yes, what is your SkillSelect EOI Number? What is your DIBP points test score?
What is the name / subclass of your current visa and when does it expire? If you are on a bridging visa, what was the subclass of your last substantive visa? 3. Personal and family details 3.1 Personal information Title
Mr
Mrs
Ms
Miss
Other
Family name Given name(s) Date of birth
Age
Current occupation
Country of birth Country of citizenship
3.2 Address Street number
Street name
City / Town
Postal code
Country
Telephone Work
Home
Mobile
Email address
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Skilled Nominated (Subclass 190) visa and Skilled Regional (Subclass 489) visa Subclass Subclass 190 and 489 Nomination Application Form 3.3 Dependants How many people are included in your application? (Please provide full family details below)
Relationship
Full name
Gender
Date of birth
(e.g. William Roberts)
(Male / Female)
(e.g. 1 March 1968)
(e.g. Husband, Spouse, Daughter)
(If necessary, complete and attach a separate sheet)
4. Living in the Northern Territory 4.1 Where do you intend to live in the NT? (Please nominate a centre, town or area in the NT) Alice Springs
Darwin
Katherine
Nhulunbuy
Tennant Creek
Other community area: Other regional centre: 4.2 Why did you choose to live in this location? (Please provide details)
4.3 Contacts Have you made contact with anyone in the location that you have identified? (If yes, please provide name and details of contact. You may also wish to attach further information regarding your contact with employers, for example, copies of emails, outcomes of discussions)
Yes
Name and position
Organisation
Contact details
(e.g. John Smith / Manager)
(e.g. Alice Springs Council)
(e.g. Phone: 08 8950 1234)
No
(Please include all contacts you have had)
Department of Business
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Skilled Nominated (Subclass 190) visa and Skilled Regional (Subclass 489) visa Subclass Subclass 190 and 489 Nomination Application Form 4.4 Friends or relatives in the Northern Territory Do you have any friends or relatives in the NT? (If yes, please indicate their relationship to you and where they live in the NT. Relatives must be related by blood or marriage) Full legal name (e.g. Sally White)
Contact number
Relationship to yourself
(e.g. 08 8951 7777)
(e.g. Sister / Friend)
Yes
No
Where they live in the Northern Territory (e.g. 123 Smith Street, City)
4.5 Friends or relatives in Australia Do you have any friends or relatives elsewhere in Australia? (If yes, please indicate their relationship to you and where they live. Relatives must be related by blood or marriage)
Full legal name (e.g. Sally White)
Contact number
Relationship to yourself
(e.g. 08 8951 7777)
(e.g. Sister / Friend)
Yes
No
Where they live in Australia (e.g. 123 Smith Street, City)
4.6 Relocation cost of living and financial resources (This information is only required from applicants who are not currently living and working in the NT)
Have you researched the cost of living in the NT? Cost of living include rental accommodation, electricity, food and transport – general information can be found at http://www.australiasnorthernterritory.com.au
Yes
No
What will it cost you to relocate to the NT if your application is successful? (Please quote all costs in Australian dollars)
4.7 Financial resources Please estimate what financial resources (available monetary funds and assets) you will bring with you if your application is successful? (Please provide a summary of all financial assets in Australian dollars and attach evidence)
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Skilled Nominated (Subclass 190) visa and Skilled Regional (Subclass 489) visa Subclass Subclass 190 and 489 Nomination Application Form 4.8 Employment Have you received an offer of employment from a NT employer? (If yes, please attach a copy of the offer of employment and provide details of a company contact)
Contact name and position
Company
Yes
No
Contact information
5. Registration and licensing 5.1 Are you a member of any professional / trade association? (If yes, please
Yes
No
5.2 Do you need to be registered and / or licensed to work in your occupation in Australia?
Yes
No
If so, are you licensed and / or registered?
Yes
No
If so, have you applied to be licensed and / or registered in Australia?
Yes
No
provide details)
6. Migration agent information (only complete if applicable) Migration agency name Migration agent name Email address Telephone Postal address 7. Applicant’s signature Signature
Department of Business
Date
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Skilled Nominated (Subclass 190) visa and Skilled Regional (Subclass 489) visa Subclass
Declaration I _______________________, hereby declare that the details provided within this application, including supporting documents, are true and correct to the best of my knowledge and belief and I undertake to inform the Northern Territory Government of any changes therein, immediately. If information within this application, including supporting documents is found to be false, untrue, misleading, or misrepresenting, I agree that the Northern Territory Government may forward any evidence to the appropriate Commonwealth and/or State or Territory Government agencies for further investigation. If I have engaged a migration agent to represent me, I acknowledge that my application, including supporting documents, has been provided with my full knowledge and consent.
Signature of Applicant: Name of Applicant:
Information Privacy Principles In accordance with the Northern Territory Information Privacy Principles:
I acknowledge that the collection of the personal information contained in my application is necessary for the functions and activities of Migration NT; I acknowledge that I am entitled to have reasonable access to the personal information contained in my application after it has been lodged with Migration NT but that Migration NT shall always be entitled to keep the documents provided; I acknowledge that Migration NT is collecting my personal information in the application and that it may be used for the following purposes: o Consider the merits of my application; o Verify the accuracy of the contents of my application (including through contacting third parties regarding my application); o Complying with relevant reporting requirements; o Compiling statistics and undertaking research (or engaging a third party to compile such statistics or research); o Participating in surveys conducted by the Northern Territory Government and national surveys; and o Complying with its obligations to any other Commonwealth, State or Territory government agency. In carrying out this purpose I acknowledge and agree that Migration NT may disclose my personal information (including sensitive personal information if any) to: o governmental agencies within the Northern Territory Government; o governmental agencies of other Australian States and Territories; o Commonwealth Government agencies; o governmental agencies throughout the world; o skills assessment bodies and or professional associations; o my employer and previous employers (and potential future employers); and o any other person or entity to which I have referred in my application, (Third Parties) I acknowledge that if I do not sign this document or do not provide the required personal information in my application, Migration NT may reject my application.
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Skilled Nominated (Subclass 190) visa and Skilled Regional (Subclass 489) visa Subclass I authorise the Northern Territory Government (through Migration NT) to:
use the information provided in this application to make necessary inquiries with any person, association, business or governmental agency to verify claims provided in the application in order to establish identity, qualifications, experience and residency and authenticate documentation retain my application and supporting documents in accordance with Northern Territory Government policies and standards share the information provided with the Third Parties described above utilise the information contained in my application and supporting documents to undertake research and inform surveys
Signature of Applicant: Name of Applicant:
Lodgement of applications Applications for Northern Territory Government nomination should be forwarded by email to:
[email protected]
Contact details For further information about our programs contact: Migration NT Outside Australia: (+61) 8 8999 5264 Inside Australia: 1800 006 282 Email:
[email protected]
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Skilled Nominated (Subclass 190) visa and Skilled Regional (Subclass 489) visa Subclass Northern Territory Government Nomination Checklist for Visa Subclasses 190 and 489 Completed NT Government nomination application form Evidence of SkillSelect EOI number issued by DIBP SkillSelect System http://www.border.gov.au/Trav/Work/Skil
Copy of main applicant’s current detailed curriculum vitae / resume Evidence of previous employment, including recent work experience related to the skilled occupation that has been nominated Certified copies of main applicant’s qualification / skill certificates and academic transcripts Certified copies of the ID pages from main applicant’s passport and any dependent family members’ passports (if in Australia also include evidence of current visa status) Certified copy of the skills assessment for main applicants nominated occupation from the relevant Australian Assessment Authority Copy of results from a recent IELTS or equivalent English language test for main applicant as evidence of English language proficiency * Evidence of financial capacity / net assets to settle in the NT – please provide evidence together with a summary of all financial assets in Australian dollars (e.g. certified copies of bank statements, share certificates, property / insurance valuations etc.) * Evidence that the applicant has undertaken research on the NT and has knowledge of the relocation costs, living expenses (e.g. food, utilities, rent, etc.), and accommodation costs involved with settling in the NT (This evidence should include a narrative explaining your reasons for wanting to migrate to the NT. Extracts from websites that are copied and pasted into your submission will not be accepted) Persuasive evidence to demonstrate employability in the NT in the nominated occupation or a copy of the letter of offer or employment contact if a NT employer has offered employment to the main applicant in their nominated occupation or closely related occupation If presently on a SC457, you will be required to provide a letter from your employer stating that: they are aware that you are applying for the SC190 or SC489 visa and they understand that when the this visa is granted you have no ties to their business and they support your application. Signed all three (3) signature clauses
* This information is not required from applicants who are already living and working in the NT. Please note that failure to supply a completed application at time of submission will result in your application being rejected as incomplete. Please note that this information may be aggregated to produce statistical information and for departmental purposes. These statistics do not identify individuals or their personal circumstances.
Department of Business
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