Form

Nomination of student dependants

919

About this form

Important Please read this information carefully before you complete this nomination. Once you have completed this nomination we strongly advise that you keep a copy for your records. This form is to be used by Student (Temporary) (Class TU) visa holders in Australia who wish to nominate members of their family unit to join them in Australia. It is to be used where the family unit members are applying separately from the student visa holder outside Australia. Under the migration legislation, a person is a member of the family unit of a Student (Temporary) (Class TU) visa holder if the person is: a partner (including spouse or de facto partner) of the student visa holder; or a dependent child of the student visa holder, or of that partner, who is unmarried and has not turned 18. AusAID or Defence sponsored students should contact AusAID or the Department of Defence for procedures. It is not necessary for you to complete this form.

evidence of payment of the Overseas Student Health Cover premium in favour of each nominated family unit member. Where stated, original documents must be provided. Where copies of original documents are required, the copies must be certified copies. In Australia, a certified copy is one certified by a Justice of the Peace or a Commissioner for Declarations or a person before whom a statutory declaration may be made under the Statutory Declarations Act 1959.

Charges
Your dependant(s)s completed student visa application form, together with the correct Visa Application Charge and this nomination, can be lodged at an Australian mission overseas. The Visa Application Charge is not refundable. Fees may be subject to adjustment at any time. Visa Application Charges may be subject to adjustment on 1 July each year. This may increase the cost of a visa. You can check the Visa Application Charge with your nearest office of the Department of Immigration and Citizenship (the department) in Australia, or from form 990i Charges, which is available from the departments website www.immi.gov.au/allforms/

How to nominate
Complete this form and send it, along with the documents you are required to provide, to your dependant(s) overseas. Your dependant(s) should complete form 157A Application for a student visa and lodge it, together with this form 919 Nomination of student dependants and the documents you have provided, at an Australian mission overseas.

Integrity of nomination
The department is committed to maintaining the integrity of the visa and citizenship programs. Please be aware that if you provide us with fraudulent documents or claims, this may result in processing delays and possibly your nomination being refused.

What documents do you need to provide?

Certified or notarised copies of all pages of your passport, including the page showing your current Student (Temporary) visa and your personal details; an original letter from your education provider stating: the course you are studying the duration of that course and anticipated completion date whether you are satisfying course requirements; evidence of, and/or declaration of access to, funds to support your nominated dependants: original bank statements an original letter from your financial institution confirming the status of your account; For details of evidence of funds required refer to the relevant visa application document checklist which is available from the departments website www.immi.gov.au/students/checklists evidence of your relationship with your nominated dependants (for example, original marriage or birth certificates); evidence that adequate arrangements have been made for the education in Australia of all your school aged dependants (children who are unmarried and who have turned 5 years of age, but have not yet turned 18 years of age), where the proposed period of stay is more than 3 months;

About the information you give

The department is authorised to collect information provided on this form under Part 2 of the Migration Act 1958. The information collected will be used for assessing the eligibility of your dependant(s) for a Student (Temporary) visa to travel to and enter and/or remain in Australia, to monitor the conduct of migration agents, and for other purposes relating to the administration of the Migration Act. The information collected might also be disclosed to agencies who are authorised to receive information relating to adoption, border control, business skills, citizenship, education, health assessment, health insurance, health services, law enforcement, payment of pensions and benefits, taxation, superannuation, review of decisions and registration of migration agents. It will also be disclosed to any agency of the Australian Government, or of a state or territory, that is responsible for or otherwise concerned with the regulation of education providers. The information on this form, including the results of any tests for Human Immunodeficiency Virus (HIV), will be used to assess your health for an Australian visa. A positive HIV or other test result will not necessarily lead to a visa being denied. Your result(s) may be disclosed to relevant Australian Government state and territory health agencies.

COMMONWEALTH OF AUSTRALIA, 2012

919 (Design date 04/12) - Page 1

In addition, the relevant registered education provider(s) may be told whether or not your visa has been granted. The collection, access, storage, use and disclosure by the department of the information you provide in this form is governed by the Privacy Act 1988 and, in particular, by the 11 Information Privacy Principles. The information form 993i Safeguarding your personal information gives details of agencies to which your personal information might be disclosed. This form is available from the departments website www.immi.gov.au/allforms/ or from any office of the department or Australian mission overseas. The department is authorised under the Migration Act 1958, in certain circumstances, to collect a range of personal identifiers including a facial image, fingerprints and a signature from noncitizens, including from visa applicants. The department requires personal identifiers to assist in assessing your identity. The department is authorised to disclose your personal identifiers and information relating to your name and other relevant biographical data to a number of agencies including law enforcement and health agencies and to other agencies who may need to check your identity with this department. Where the department obtains personal identifiers they will become part of your official record with the department. The department is involved in international information exchanges with a number of countries, including the United Kingdom, the United States of America, Canada and New Zealand. These international information exchanges may involve the sharing of personal identifiers, including facial images and fingerprint data, collected by immigration agencies such as this department. If, as a result of this sharing between countries, there is a match with your personal identifiers, the department will disclose your biographical data, copies of travel and other identity documents or information from such documents, your immigration status and immigration history (which may include any immigration abuse and offences) and any criminal history information relevant to immigration purposes. The purpose of such disclosure would be to help confirm your identity and determine if you have presented to the department and the other agency under the same identity and with similar claims. For more detailed information you should read information form 1243i Your personal identifying information, which is available from the departments website www.immi.gov.au/allforms/ or from any office of the department or Australian mission overseas.

Home page www.immi.gov.au General Telephone 131 881 during business hours enquiry line in Australia to speak to an operator (recorded
information available outside these hours). If you are outside Australia, please contact your nearest Australian mission.

Please keep these information pages for your reference

919 (Design date 04/12) - Page 2 COMMONWEALTH OF AUSTRALIA, 2012

Form

Nomination of student dependants

919

Please use a pen, and write neatly in English using BLOCK LETTERS. Tick where applicable

Your details
1
Your family name in English Family name Given names

10 Relationship status
Married Engaged De facto Separated Divorced Widowed Never married or been in a de facto relationship

2 3 4

Sex Date of birth Place of birth Town/city Country

Male
DAY

Female
MONTH YEAR

11 Your immigration file number (if known)

Overseas In Australia

12 Details from your passport

Passport number Country of passport
DAY MONTH YEAR

Citizenship/Nationality

Date of issue Date of expiry

Your current Australian residential address

Issuing authority/ Place of issue as shown in your passport

POSTCODE

13 Details of identity card or identity number issued to you by your

government (if applicable) eg. National identity card. Note: If you are the holder of multiple identity numbers because you are a citizen of more than one country, you need to enter the identity number on the card from the country that you live in. Identity number

Address for correspondence (If the same as your residential address, write AS ABOVE)

POSTCODE

Country of issue

Your telephone numbers Office hours After hours Personal/private mobile/cell

(AREA CODE (AREA CODE ) )

14 Give details of the Australian visa that you currently hold

Visa label number V < If you were granted a visa without a label, give the 13-digit visa grant number (as shown on the letter that notified you of visa grant). Office of visa issue

Do you agree to the department communicating with you by fax, e-mail or other electronic means? No Yes Fax number E-mail address Note: If this application is refused, you will be notified by mail Give details
(AREA CODE )

DAY

MONTH

YEAR

Date of issue

COMMONWEALTH OF AUSTRALIA, 2012

919 (Design date 04/12) - Page 3

15 Give details of the course that you are currently studying

Name of your current course Name of the education provider or training body

2. Name in English Ethnic script Relationship to you Date of birth (DAY/MONTH/YEAR) Place of birth Citizenship/ Nationality Is evidence of your relationship attached? 3. Name in English Ethnic script Relationship to you Date of birth (DAY/MONTH/YEAR) Place of birth Citizenship/ Nationality No Yes

Course duration

DAY

MONTH

YEAR

DAY

MONTH

YEAR

to

16 Do you have any applications before this department either in Australia

or overseas? No Yes Give details Type of application When did you lodge this application? Where did you lodge this application?

17 Do you have:
adequate means to support yourself and your dependants? No Yes You may be asked to provide supporting documents

Is evidence of your relationship attached? 4. Name in English Ethnic script Relationship to you Date of birth (DAY/MONTH/YEAR) Place of birth Citizenship/ Nationality Is evidence of your relationship attached? 5. Name in English Ethnic script Relationship to you Date of birth (DAY/MONTH/YEAR) Place of birth Citizenship/ Nationality Is evidence of your relationship attached?

No

Yes

obtained health cover for your dependants? No Yes Please provide evidence

enrolled any school aged dependants (that is, children who are unmarried and who have turned 5 years of age, but have not yet turned 18 years of age) who are included in this nomination, in a school in Australia? No Yes Please provide evidence of enrolment, including details of any school fees

No

Yes

Members of the family unit coming to Australia

18 Give details of members of the family unit who will be joining you in
Australia while you hold a student visa.

(Members of your family unit may include your partner and any dependent children of you or your partner who are unmarried and have not turned 18.)
1. Name in English Ethnic script Relationship to you Date of birth (DAY/MONTH/YEAR) Place of birth Citizenship/ Nationality Is evidence of your relationship attached?
919 (Design date 04/12) - Page 4

No

Yes

If insufficient space, please attach a separate sheet

No

Yes
COMMONWEALTH OF AUSTRALIA, 2012

19 Overseas contact address of members of your family unit who will be

joining you in Australia In English

Declaration
WARNING: Giving false or misleading information is a serious offence.

25 I declare that the information supplied on and with this nomination form
is complete, true and correct in every particular.
POSTCODE

Ethnic script

Your signature

DAY

MONTH

YEAR

Date
POSTCODE

20 Overseas contact telephone numbers of members of your family unit

who will be joining you in Australia
COUNTRY CODE AREA CODE ) ( ) NUMBER

We strongly advise that you keep a copy of this nomination and all attachments for your records.

Office hours After hours Personal/private mobile/cell

) (

Assistance with this form

21 Did you receive assistance in completing this form?
No Yes Title: Mr Go to Question 25 Please give details of the person who assisted you Mrs Miss Ms Other

Family name Given names Address

POSTCODE

Telephone number or daytime contact

COUNTRY CODE AREA CODE ) ( ) NUMBER

Office hours Mobile/cell

22 Is the person an agent registered with the Migration Agents Registration

Authority (MARA)? No Yes Go to Question 25

23 Is the person/agent in Australia?

No Yes Go to Question 25

24 Did you pay the person/agent and/or give a gift for this assistance?
No Yes

COMMONWEALTH OF AUSTRALIA, 2012

919 (Design date 04/12) - Page 5