Visiting Academic Visa
Data Collection Form
Contact Person in Faculty/School/Centre
Name
Phone
Campus
Email
Faculty/Division/Office
School/Section/Centre
Applicant Details
Full Name (as shown on Passport)
Date of Birth (dd/mm/yyyy)
Gender
Male
Female
Residential Address
Will the applicant be accompanied by any family members?
Full Name (as shown on Passport)
No
Date of Birth (dd/mm/yyyy)
Yes (please supply details below)
Gender
Relationship
Nomination Information (If insufficient space, attach a word file and make a notation in each box below)
1. What are the objectives of the proposed training?
2. What are the additional or enhanced skills to be acquired by the nominated person?
3. Describe the main tasks, responsibilites and any other information about the position.
(a) Tasks
(b) Responsibilites
Nomination Information (continued)
(c) Other Information
4. Describe the qualifications, essential skills, employment experience and registrations/licences required for the position.
(a) Relevant Qualifications/Academic Merit
(b) Relevant Skills
(c) Registration/Licensing/Professional Membership Requirements (if applicable)
5. English Laguage Skills
(a) Has an assessment been made of the nominated visitors' English language skills?
Yes
No
(b) Are you satisfied that the nominated person's English language skills are sufficient to
undertake the occupational training program?
Yes
No
(c) Are you satisfied that the nominated person's English language skills are sufficient to
understand and comply with Work Health Safety requirements?
Yes
No
Important Information for Submission
This form will not submit unless all of the required fields have been completed. Please ensure any supporting documents,
including the applicant's CV and copy of their passport(s) details are attached when submitting.
Submit to HR for Processing
Last reviewed: April 2017
Asset ID # 425523