*
Family Name
*
Given Names
*
Residential Address
Postal
Address
Home Telephone
No.
Fax No.
Mobile
/ Cell Phone No.
Email Address
*
Gender
*
Marital Status
Single
Married
Others
Date
of birth (dd/mm/ccyy)
Place
of birth
Citizenship
Passport
No.
Issuing
country of passport
Albania
Algeria
Angola
Antigua/Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Bermuda
Bhutan
Bolivia
Bosnia
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape
Verde
Central
African(Rep)
Chad
Chile
China
Cuba
Colombia
Comoros
Congo (Rep)
Congo (Dem. Rep)
Costa Rica
Cote d'Ivoire(Rep)
Croatia
Cyprus
Czech (Rep)
Denmark
Dominica
Dominican Republic
Ecuador
Egypt
El
Salvador
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
French Polynesia
Gambia
Germany
Ghana
Greece
Greenland
Grenada
Guam
Guatemala
Guinea
Guinea-Bissau
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea South)
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Mauritania
Mauritius
Mexico
Moldova
Monaco
Mongolia
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Panama
Papua-New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Romania
Russia
Rwanda
Saint Christopher
Saint
Lucia
Saint Vincent/Grenadines
Samoa
Sao Tome/Principe
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri
Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad/Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United
Kingdom
Uruguay
USA
Uzbekistan
Vanuatu
Vatican
Venezuela
VietNam
Yemen
Yugoslavia
Zambia
Zimbabwe
Other Country
How
did you find MMSA ?
Do
you or your spouse have a relative
in Australia who is willing to sponsor
you?
Where does
your relative live ?
Town
Post Code
What
is your relationship to the relative
?
Not
Applicable
Child
Parent
Brother
Sister
Niece
Nephew
First
Cousin
Grandchild
Other
relation
How
long has your relative been an Australian
resident?
Do
you have the funds to deposit AUD$100,000
in a designated security for 12
months ? (Not a requirement
but additional bonus points apply)