Transcript
[This record is a blank form.]
[Page 1.]
[' "C" ' is handwritten in blue ink in the top right corner.]
[black and white drawing of Australian coat of arms in top left corner.]
Department of Immigration
[Dividing line.]
selection assessment
[In the top right corner, four blank boxes labelled 'POST', 'REFERENCE NUMBER', 'SCHEME', 'NUMBER OF DEPENDANTS'.]
FAMILY NAME OF APPLICANT
GIVEN NAMES
[Heading] ASSESSMENT SUMMARY
OCCUPATIONAL CLASSIFICATION
Worker Requisition No
Occupation
DESIGNATION
SIGNATURE [followed by space for signature and date]
[The following section is divided into a table, with criteria presented in rows and empty tick boxes for 'grades' in columns. The far right column, containing all grades 'Un-favourable' and 'Reject' is separated from the others by a vertical line]
SELECTION
PART (a) Economic Assessment
Short Term
Good
Adequate
Poor
Un-favourable
Long Term
Good
Adequate
Poor
Un-favourable
PART (b) Personal & Social Assessment
APPLICANT
Good
Adequate
Poor
Unfavourable
SPOUSE
Good
Adequate
Poor
Un-favourable
[thin dividing line]
CHARACTER AND LIAISON
(I) Character
Clear
Minor
Un-favourable
(II) Liaison
Accept
Un-favourable
[thin dividing line]
MEDICAL
(I) Medical
Accept
(II) X-Ray
Accept
[A blank space in the centre 'column' for the Medical and X-Ray section is labelled '(Note Special Conditions)']
[A single large check-box in the right 'column' for the Medical and X-Ray section, labelled 'Reject']
[Strong dividing line]
[Heading] DECISION
[A check-box labelled 'Accept', connected to a larger box labelled 'SCHEME']
[Two check-boxes under the subheading 'Defer', labelled 'Employment' and 'Other']
[A checkbox labelled 'Review (State action required)']
[A large checkbox in the right-most column labelled 'Reject']
Signature
[Space for date]
Designation
[strong dividing line]
[Heading] FILE ACTION RECORD
[Three boxes across the page, labelled 'FORMER PAPERS', 'LATER PAPERS', and 'DISPOSAL/ARCHIVAL ACTION']
[Two tables in two columns. The left-hand table is aligned under the boxes 'FORMER PAPERS' and 'LATER PAPERS'. The right-hand table is aligned under the box 'DISPOSAL/ARCHIVAL ACTION'. Each table has six rows and the column headings 'Folio Number', 'Referred To', 'Date of Referral', 'Clearing Officer's Initials', 'Date Cleared'.]
VISA DETAILS
Number
Date Issued
Valid to
Initials
Extended to
Initials
DEPARTURE ARRANGEMENTS
Flight Number/Name of Ship
Date Departing
Date Arriving Australia
[page 2]
[Subheading] FAMILY COMPOSITION
(Completed before interview from application form. Migration Officer to check during interview.)
APPLICANT
[Five checkboxes labelled 'Single', 'Married', 'Widowed', 'Divorced', 'Other']
Number of Children [blank box for answer, followed by table with two rows labelled 'Age' and 'Sex', and several columns]
Certificates seen (Write "R" in appropriate box where certificate Is required but was not presented at interview)
[Nine checkboxes labelled 'Citizenship', 'Birth', 'Marriage', 'Divorce', 'Separation', 'Death', 'Custody of children', 'Adoption papers', 'Passport/Certificate of Identity']
COMMENT:
[blank space]
[Subheading] DISPOSITION OF RELATIVES
[Table labelled 'Location', with columns for 'Applicant' and 'Spouse', and rows labelled 'In Australia', 'In Home Country', and 'Elsewhere']
Is the applicant personally nominated by relatives?
[Two checkboxes labelled 'Yes' and 'No']
(If yes, relationship of nominator to nominee to be stated)
[blank space]
Joining relatives but not personally nominated?
[Two checkboxes labelled 'Yes' and 'No']
[Heading] Interview Report
[Heading] PART A – ECONOMIC FACTORS
A1. AGE
(Migration Officer to indicate applicant's exact age in appropriate box)
[Four boxes labelled '18-29', '30-39', '40-49', '50& over']
A2. EDUCATIONAL QUALIFICATIONS
(Migration Officer to check applicant's qualifications at interview)
APPLICANT
[Five checkboxes labelled 'Completed Secondary, Technical or Tertiary', 'Some Secondary', 'Completed Primary', 'Some Primary', 'Illiterate'.]
SPOUSE
[Four checkboxes labelled 'Completed Secondary, Technical or Tertiary', 'Some Secondary', 'Completed Primary', 'Some Primary'.]
A3. EMPLOYMENT (Migration Officer to assess at interview)
Present Occupation [blank space for answer]
Proposed Occupation in Australia [blank space for answer]
OCCUPATIONAL SKILLS based on skills recognised in Australia. (Technical Adviser assessment to be used where applicable.)
[List of seven items with checkboxes:]
Professional or Skilled Tradesman
University Graduate, Diplomate*
Technical or Sub-professional
Seal-skilled
Administrative, Clerical or Sales
Self Employed
Unskilled
*Professional applicant should not be given credit in this category [university graduate] if assessed in the previous one [professional or skilled tradesman].
If employment is not available or, if qualifications are not recognised is the applicant prepared to accept……
….employment at a lower level?
[Three checkboxes labelled 'Yes', 'Yes initially', 'No']
…. Employment in another field?
[Three checkboxes labelled 'Yes', 'Yes initially', 'No']
PHYSICAL, AGE OR OTHER FACTORS which may have a bearing on applicant's employment prospects.
[blank space for answer]
AVAILABILITY OF EMPLOYMENT for applicant in area he/she is proceeding to. (where employment is assured, rate as a strong and continuing demand.)
[Two rows of four checkboxes. The rows are labelled 'Short Term' and 'Long Term'. The columns of checkboxes are labelled 'Strong and continuing demand', 'Limited but reasonable prospects', 'Poor prospects', and 'No demand'.]
EXPERIENCE in employment for the past 10 years relevant to intended employment.
[Three boxes labelled '5 years +', '1 to 5 yrs', 'Under 1 yr'.]
EMPLOYMENT RECORD in relation to local employment, nature of occupation and industry.
(Migration Officer to assess employment gaps, having due regard to those for which a satisfactory explanation is not available, changes in employer, changes in occupation, and the nature of occupation and industry.)
[Three checkboxes labelled 'Good', 'Acceptable', 'Unacceptable'.]
COMMENT on any aspect of Employment as necessary
[blank space for answer]
[page 3]
A4 KNOWLEDGE OF ENGLISH
(Applicants whose native language is English should be rated as 'Fluent')
[Four checkboxes labelled 'Fluent', 'Less than fluent but good', 'Working Knowledge (can understand and make self understood', 'No knowledge'.]
If relevant, does knowledge of English appear sufficient for employment in occupation in Australia?
[Two checkboxes labelled 'Yes' and 'No'.]
[Blank space for comments]
(Interviewing Officer to comment if applicant is difficult to understand)
A.5 VALUE OF ASSETS in relation to standard in local area. (State value in appropriate box.)
[Three boxes labelled 'above average in local area', 'Average', 'Below average'.]
A.6 FUNDS FOR TRANSFER TO AUSTRALIA
(State amount in appropriate box)
[Four boxes labelled 'Above $10,000', '$10,000 - $1000', '$1000 - $100', 'Less than $100'.]
[The following area is highlighted with a thick grey border.]
ASSESSMENT OF ECONOMIC FACTORS
[Two rows of four checkboxes. The rows are labelled 'Short Term' and 'Long Term'. The four columns are labelled 'Good', 'Adequate', 'Poor', 'Unfavourable'.]
[End highlighted section.]
[Heading:] PART B – PERSONAL & SOCIAL FACTORS
B.1 ATTITUDE TO MIGRATION
(Attitude to difficulties likely to be encountered in leaving home country and in starting life in a new environment)
[Two rows of four checkboxes. The rows are labelled 'APPLICANT' and 'SPOUSE'. The four columns are labelled 'Very good', 'Good', 'Acceptable', 'over or under confident'.]
If either applicant or spouse does not support migration plans, rate as 'under confident' and give details:
[Blank space for answer.]
B.2 EXPECTATIONS
(Realistic expectations of what Australia has to offer in relation to background and experience)
[Two rows of three checkboxes. The rows are labelled 'APPLICANT' and 'SPOUSE'. The three columns are labelled 'Appropriate and realistic', 'Appropriate except on minor aspects', 'Unrealistic'.]
Comment:
[Blank space for answer.]
B.3 RESPONSIVENESS
(Readiness and aptness of responses, and relevance of questions asked)
[Two rows of four checkboxes. The rows are labelled 'APPLICANT' and 'SPOUSE'. The four columns are labelled 'Very good', 'Good', 'Adequate', 'Inadequate'.]
Comment.
[Blank space for answer.]
B.4 INITIATIVE
(The extent to which there is any evidence of dependency or part dependency on welfare services and/or relatives)
[Two rows of three checkboxes. The rows are labelled 'APPLICANT' and 'SPOUSE'. The three columns are labelled 'No apparent dependency', 'Some dependency but not over-dependent', 'Over-dependent'.]
Comment.
[Blank space for answer.]
[page 4]
B.5 PRESENTATION
Appearance
[Two rows of four checkboxes. The rows are labelled 'APPLICANT' and 'SPOUSE'. The four columns are labelled 'Very good', 'Good', 'Acceptable', 'Not acceptable.]
Personal Hygiene
[Two rows of two checkboxes. The rows are labelled 'APPLICANT' and 'SPOUSE'. The two columns are labelled 'Acceptable' and 'Not acceptable'.]
Speech
[Two rows of three checkboxes. The rows are labelled 'APPLICANT' and 'SPOUSE'. The three columns are labelled 'Normal', 'Slight defect', 'Marked defect'.]
Behaviour
[Two rows of three checkboxes. The rows are labelled 'APPLICANT' and 'SPOUSE'. The three columns are labelled 'Appropriate', 'Appropriate except for minor aspects', 'Not appropriate'.]
Comment (including comment on children)
(Indicate in box if children not acceptable)
[Checkbox labelled 'Not acceptable']
[Blank space for answer.]
B.6 FAMILY UNITY
[Three checkboxes labelled 'Good', 'Acceptable', 'Evidence of disunity'.]
Comment
[Blank space for answer.]
B.7 COMMENT ON ANY CONVICTIONS
(Includes applicant, spouse and other family members, where applicable)
[Two checkboxes labelled 'Question asked', 'Convictions']
[Blank space for answer.]
[The following area is highlighted with a thick grey border.]
ASSESSMENT OF PERSONAL AND SOCIAL FACTORS
[Two rows of four checkboxes. The rows are labelled 'Short Term' and 'Long Term'. The four columns are labelled 'Good', 'Adequate', 'Poor', 'Unfavourable'.]
[End highlighted section.]
[Strong dividing line]
APPLICANT COUNSELLED ON:
[List of items with checkboxes, as follows:]
Hostels
Education
National Service
Availability of Housing
Tools of Trade
Liability of sea/air travellers for unaccompanied baggage
Employment opportunities for women
Customs and quarantine responsibility of migrants
Health and Social Services
Discharge of financial commitments
[End list]
Other matters discussed at interview:
[Blank space for answer]
[dividing line]
[Heading:] General Comment
[Blank space for answer.]
[The following area is highlighted with a thick grey border.]
INTERVIEWING OFFICER'S RECOMMENDATION (State Scheme)
[Blank space for answer.]
INTERVIEWING OFFICER'S NAME
[Blank space for answer]
SIGNATURE]
[Marked space for signature and date]
[End highlighted section]
[page 5]
[' "A" ' is handwritten in blue ink in the top right corner]
[Heading:] COMMONWEALTH OF AUSTRALIA
[Heading:] EDUCATIONAL QUALIFICATIONS AND EMPLOYMENT RECORD
FULL NAME OF APPLICANT: [space for answer]
(all answers to be typewritten if possible)
[dividing line]
1. FINAL SECONDARY SCHOOL EXAMINATION:
[A blank table with four rows and six columns. The columns are labelled 'Subject', 'Level', 'Subject', 'Level', 'Subject', Level'.]
2. TRADE QUALIFICATIONS: *
Name of Institution
Years of Study
a) Part time
b) Full time
Course
Certificates Received
3. TERTIARY QUALIFICATIONS: *
Name of Institution
Years of Study
a) Part time
b) Full time
Course
4. EMPLOYMENT RECORD:
[A blank table with four columns, labelled 'DATES', 'Employed as', 'Name and Location of Employer', 'Description of Industry'. There are several rows of lines to write on, labelled 'FROM:' and 'TO:' in the 'DATES' column.]
* Photocopies of original certificates and transcripts of courses studied are to be attached. If the documents are not in English it is essential that translations be attached also.
[page 6]
[' "B" ' is handwritten in blue ink in the top right corner]
[Heading:] COMMONWEALTH OF AUSTRALIA
[Heading:] SELECTION INTERVIEW REPORT
POST:
FILE NO.:
1. PRINCIPAL APPLICANT:
[blank space for answer, labelled '(FAMILY NAME)', '(GIVEN NAMES)']
2. ASSESSMENT OF DESCENT:
[Three rows of three boxes. The rows are labelled 'Principal applicant', 'Spouse', 'Children'. The columns of boxes are labelled 'EUROPEAN', 'MIXED DESCENT', 'NON-EUROPEAN'.]
3. TYPE OF APPLICATION:
[Two boxes labelled 'SPONSORED' and 'UNSPONSORED'
Relationship to sponsor (if applicable) [blank space for answer.]
State file No. [blank space for answer.]
4. APPEARANCE/PRESENTATION OF APPLICANT AND ANY FAMILY MEMBERS:
[Blank space for answer.]
5. GENERAL KNOWLEDGE OF AUSTRALIA (SOCIAL/ECONOMIC/POLITICAL):
[Blank space for answer.]
6. PARTICULARS OF ANY PRE-ARRANGED EMPLOYMENT IN AUSTRALIA:
[Blank space for answer.]
7. PREFERRED STATE OR TERRITORY OF RESIDENCE IN AUSTRALIA:
[Blank space for answer.]
8. ASSESSMENT OF CAPACITY TO INTEGRATE
[Blank space for answer.]
9. GENERAL COMMENTS:
[Blank space for answer.]
10. RECOMMENDATION:
[Three boxes labelled 'ACCEPT', 'DEFER', 'REJECT'.]
INTERVIEWING OFFICER'S SIGNATURE: [Blank space for answer.]
DATE: [Blank space for answer.]
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