Application Form APPLICATION FORM – MIGRATE Name(Required) First Last Email(Required) Phone(Required)Gender(Required)MaleFemaleNon-binaryAge(Required) Nationality(Required) Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands What type of visa are you interested in applying for?(Required) Skilled Independant & Nominated Visas (Subclass 189 -190) Employer Nominated and Regional Visa (Subclass 186 – 187) Temporary Skill Shortage (Subclass 482) Skilled Provisional (Subclass 491 – 494) Partner Visa (Subclass 820-309) Student Visa (Subclass 500) Any / Unsure Other Please specify Have you previously applied for any visa in Australia?(Required)YesNoUnsureWhat was the outcome?(Required) Are you a medical practitioner?(Required)YesNoOtherFrom which medical school did you graduate?(Required) What is your current medical specialty if applicable?(Required)Addiction MedicineAnaesthesiaDermatologyEmergency MedicineGeneral PracticeIntensive Care MedicineMedical AdministrationObstetrics and GynaecologyOccupational and Environmental MedicineOphthalmologyPaediatrics and Child HealthPain MedicinePalliative MedicinePathologyPhysicianPsychiatryPublic Health MedicineRadiation OncologyRadiologyRehabilitation MedicineSexual Health MedicineSport and Exercise MedicineSurgeryNot applicableOtherPlease specify(Required) What is your AMC status?(Required)I have not startedI am registered with the AMC but have not taken any exams yet.I have passed the AMC MCQ examI have passed both AMC MCQ and AMC ClinicalI am on a specialist pathwayOtherPlease specify What qualifications do you hold?(Required) Does your work experience match your qualifications? If not, what is your work experience?(Required) How many years of work experience do you have?(Required)No experience1-2 years3-4 years5-7 years8+ yearsWhat is your English language status?(Required)I am not proficient in English.I am proficient in English but have not taken a test yet.I have taken an English test (IELTS/OET/…)OtherWhat was your English test outcome?(Required) What is your Australian work status?(Required)I am not working and have not received a job offer yet.I have received a job offer but have not taken the PESCI yet.I am working under supervision.I am working with general/specialist registration.OtherWhat is your marital status?SingleMarriedDe factoSeparatedDivorcedWidowedDo you have children?YesNoPlease specify What is your PESCI status?(Required)I have not booked the exam yet.I have booked the exam.I failed the exam and might re-attempt.I passed the examOtherOn a scale of 1 – 10, how serious are you in obtaining a visa or permanent residency in Australia?(Required)12345678910What are the 3 main challenges you are facing in your migration efforts?(Required)Minimum 50 wordsWhat happens if you fail to obtain your Visa or permanent residency in Australia?(Required) How would you feel if you successfully obtained your accreditation and/or desired visa because of our support?(Required) If our services have helped you obtain accreditation and/or your desired visa, how likely are you to recommend us to others?(Required) What is your budget for the migration services and expenses?(Required)The greater your budget, the higher the prospect of obtaining the visa$10,000 – $15,000$15,001 – $20,000$20,001 – $30,000$30,001 – $50,000$50,000+Are you interested in assistance with job placement in Australia?(Required)YesNoMaybeWould you like information about our AMC exam preparation courses?(Required)YesNoMaybeWould you like information about our PESCI preparation courses?(Required)YesNoMaybeHow did you find us?(Required)AMC WebsiteFriend / ColleagueGoogle AdsInternet searchEmail CampaignFacebookYoutubeLinkedInOtherPlease specify Is there anything else you would like to tell us? 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