W003 Woomera Prohibited Area Coordination Office APPLICATION FOR APPROVED PERSON STATUS Pursuant to Woomera Prohibited Area Rule 2014 or Defence Force Regulations 1952 as applicable, use this form to: Apply for Approved Person Status in the Woomera Prohibited Area INSTRUCTIONS (1) Form completion All questions are to be answered: If a question is not applicable, enter N/A or if the answer is not known, enter N/K. Information is to be provided in English. Dates are to be provided in full using the DD/MM/YYYY format. Do not use abbreviations or acronyms. Space is provided at the end of each section to present additional information. Photographic Identification: Applications must include a copy of photographic identification issued by a Commonwealth or State Government body (for example – Passport or Drivers Licence). An International Passport may be acceptable if no Commonwealth or State Government issued identification is available. An International Passport in a language other than English must be accompanied by a certified English translation. The copy can be a scanned image or photocopy of both sides of the identification document and should be attached to this form. Defence will process the application within 20 Business Days of receipt of a correctly completed application. Defence may also require additional information or documents in relation to the application. The processing time will be extended by the time it takes for the additional information or documents to be provided. An applicant who has previously been granted Approved Person Status under a Permit or Deed of Access and requires approval under a different Permit or alternative access arrangements is only required to complete Sections 1a and 7 of the form. If the status has less than six months validity remaining you may be requested to complete all fields. (2) Form submission Once completed by the applicant, the form should be given to the Permit/Deed Holder or sponsor. The Permit/Deed Holder or sponsor should submit the form to the Woomera Prohibited Area Coordination Office (WPACO): Email: [email protected] (preferred method) Mail: WPACO R1-1-D Zone, PO Box 7901 Canberra BC ACT 2610 (3) Access to the Woomera Prohibited Area The granting of Approved Person status does not give the right of entry onto the Woomera Prohibited Area. The Permit/Deed Holder or sponsor must seek approval for the Approved Person to enter the Woomera Prohibited Area. The Access Form, W007 is available from the Woomera Prohibited Area Coordination Office website at http://www.defence.gov.au/woomera/forms.htm. The completed form W007 is to be submitted to the Woomera Test Range: Email: [email protected] (preferred method) Mail: Woomera Test Range, PO Box 157, WOOMERA SA 5720 PRIVACY STATEMENT This information is being collected by the Woomera Prohibited Area Coordination Office (WPACO) on behalf of the Department of Defence as authorised by the Woomera Prohibited Area Rule 2014. A copy of the WPACO Privacy Policy is available at www.defence.gov.au/woomera and details how personal information is collected, used and stored. The WPACO Privacy Policy contains information on how an individual may apply for access to their personal information and how an individual may apply to have their personal information amended. The Defence Privacy Policy also contains information for individuals on how to make a privacy complaint to Defence if they consider Defence may have breached the Australian Privacy Principles. Woomera Prohibited Area Coordination Office Page 1 of 4 W003 Version 2.0 W003 APPLICATION FOR APPROVED PERSON STATUS Note: All fields are to be answered. If a question is not applicable, enter N/A. Does applicant currently have Approved Person Status under another Permit or Deed of Access? Yes (Complete Sections 1a and 7 only ) No (Complete all Sections) Section 1a: APPLICANT DETAILS Last name First and Middle Name(s) All previous/other name(s) used including Place of Birth former married City names Section 1b: APPLICANT DETAILS CONTINUED Home address Suburb/Town/City Country Current citizenship Other citizenships ever held Date of arrival in Australia Place of naturalisation Additional information: Date of Birth Country State Australian Other/s (specify): Date naturalised Certificate number Section 2 CURRENT EMPLOYMENT Note: Postcode Tick this box if currently unemployed All fields are to be answered. If a question is not applicable, enter N/A. Employer’s name Address Suburb/Town/City Country Start Date Current occupation Employment/education speciality (eg. communications, security, electronics, engineering etc) Additional information: State Postcode Telephone (include area code) Qualifications Section 3 PREVIOUS EMPLOYMENT/SCHOOLING (Previous 2 years) Provide full details of previous employment or education/schooling for the previous 2 years. Details are to include all types of employment and education Employer/educational institution Employer/Schooling Address Suburb/Town/City Country Start Date Previous occupation Employment/education speciality (eg. communications, security, electronics, engineering etc) Woomera Prohibited Area Coordination Office State Postcode End Date Qualifications Page 2 of 4 W003 Version 2.0 Section 3 PREVIOUS EMPLOYMENT/SCHOOLING (Previous 2 years) - Continued Employer/educational institution Address Suburb/Town/City Country Start Date Previous occupation Employment/education speciality (eg. communications, security, electronics, engineering etc) Are more fields required? No State Postcode End Date Qualifications Yes (Please attach separate sheet with additional information) Additional previous employment/schooling information. Section 4 INTERNATIONAL TRAVEL (previous 2 years) Have you travelled overseas in the previous 2 years? No (Go to Section 5) Yes Destination Purpose of travel Arrival Date Departure Date Destination Purpose of travel Arrival Date Departure Date Destination Purpose of travel Arrival Date Departure Date Destination Purpose of travel Arrival Date Departure Date Destination Purpose of travel Arrival Date Departure Date Destination Purpose of travel Arrival Date Departure Date Destination Purpose of travel Arrival Date Departure Date Destination Purpose of travel Arrival Date Departure Date Are more fields required? No Yes (Complete Section 4) (Please attach separate sheet with additional information) Additional International Travel information: Woomera Prohibited Area Coordination Office Page 3 of 4 W003 Version 2.0 Section 5: OTHER INFORMATION 1. Do you have regular contact with persons in a country other than Australia? Yes No 2. Have you ever had contact with foreign officials or worked for a foreign government in a civil or military capacity? Yes No 3. Do you have personal business ties in a country other than Australia? Yes No 4. Do you hold any financial interests in a country other than Australia? Yes No 5. Do you maintain a residence in a country other than Australia? Yes No 6. Do you have any family members who are permanent residents of a country Yes No other than Australia? If you indicated ‘yes’ to any of the above questions, please provide detailed information below and attach any supporting documents. e.g. for military service include, time served, position held, qualifications attained: for contacts include nationality, position held, relationship. Section 6: PHOTOGRAPHIC IDENTIFICATION Attach copy of Photographic Identification (front and back) to form Section 7: CERTIFICATION Applicant: I certify to the best of my knowledge and belief that the information given in this form is correct and complete and that I will notify the Woomera Prohibited Area Coordination Office of any changes in my circumstances. Signature of Applicant Printed Name Date Permit/Deed holder (Note: to be signed by authorised Company Representative) or sponsor Signature of sponsor Printed Name Position in Company Date Company Name of Permit/Deed holder(s) or sponsor CHECKLIST All questions answered. If a question is not applicable, enter N/A. If the answer is not known, enter N/K. Photographic Identification attached (front and back). If applicable, attach additional information sheet. Woomera Prohibited Area Coordination Office Page 4 of 4 W003 Version 2.0
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