SSI Community Support Program EOI

I have read the eligibility criteria noted in the "Community Support Program (CSP) requirement-eligibility " document and meet the criteria.

I understand that $150 is non-refundable and does not guarantee my acceptance into the SSI Community Support Program.

I understand that the SSI Community Support Program Visa Application costs money and that a supporter who is financially capable of supporting this application is a program requirement.

Do you have citizenship of any other country apart from your birth country? *

YesNo

If you select Yes you will not be alowed to submit this form

Have you identified an Australian Supporter to provide financial and practical support to your visa application to enter Australia under the Community Support Program? *

YesNo

Family, Friends, Community group, Employer

ObjectId

Applicant Details

Family Name *

Given Name(s) *

Gender *

Male FemaleGenderfluid/Non-BinaryPrefer not to answer

Date of Birth *

Email Address *

Phone number *

Details of family members to be included in this application for the Community Support Program

Number of additional family members (excluding the Principal Humanitarian Applicant) *

Additional Family Member 1 Details

Family Name *

Given Name(s) *

Date of Birth *

Relationship *

Additional Family Member 2 Details

Family Name *

Given Name(s) *

Date of Birth *

Relationship *

Additional Family Member 3 Details

Family Name *

Given Name(s) *

Date of Birth *

Relationship *

Additional Family Member 4 Details

Family Name *

Given Name(s) *

Date of Birth *

Relationship *

Additional Family Member 5 Details

Family Name *

Given Name(s) *

Date of Birth *

Relationship *

Additional Family Member 6 Details

Family Name *

Given Name(s) *

Date of Birth *

Relationship *

Additional Family Member 7 Details

Family Name *

Given Name(s) *

Date of Birth *

Relationship *

Additional Family Member 8 Details

Family Name *

Given Name(s) *

Date of Birth *

Relationship *

Additional Family Member 9 Details

Family Name *

Given Name(s) *

Date of Birth *

Relationship *

Additional Family Member 10 Details

Family Name *

Given Name(s) *

Date of Birth *

Relationship *

Nationality (if stateless, please list country of habitual residence) *

Ethnicity *

Religion *

Current Country of Residence *

Date of arrival to the current residence *

Legal status in country of current residence *

Language spoken at home *

How well the applicant can speak English *

Reason for leaving your birth country *up to 300 words

Are you registered under UNHCR *

YesNo

Do you have any other humanitarian visa pending with the Australian Government *

YesNo

Has any individual listed above had an Australian visa refused? *

YesNo

Australian Supporter Details

Supporter's First Name *

Supporter's Last Name *

Supporter’s Address *

Street address *

Suburb *

State *

Postcode *

Supporter's Phone *

Supporter's Email *

Supporter's Citizenship status *

Supporter’s employment status *

Legal representative or migration agent details

Complete this section only if applicable

Business Name

First Name of lawyer or migration agent

Last Name of lawyer or migration agent

Phone

Please enter your card details below:

Payment *

Pay

Save and Complete Later