Online Registration for Australian Visa Applicants

This online registration form aims to reduce registration time by having most of the applicant's information ready upon arrival at the registration area. Pre-registered applicants should only need to have their biometrics captured upon arrival at the reception area.

INSTRUCTIONS:

Before accomplishing this form, please know your H.A.P. ID, Visa Subclass Name and Number, and the Lodgement Office where your visa application was filed. Temporary Visa Applicants must also know their Length of stay in Australia.
Answer all applicable fields. For items that do not apply, please type 'Not Applicable'.
Once all fields have been filled out, Click on the 'Preview' button. The next step will display a preview of all data entered.
Review data for errors. Use the form to correct them as needed, click 'Preview', to preview data to be submitted.
If all data are correct, click on the 'Register' button to submit your registration.

PLEASE COMPLETE REGISTRATION BEFORE PRINTING THIS PAGE.
Your registration has not been submitted. Refer to the instructions found at the beginning of the registration form to complete your registration. This printout will not be honored when presented at SLEC.

Please select your preferred St. Luke's Extension Clinic location:

Preferred Date of Medical Examination

Is this your first medical examination for the Australian Embassy?
  Yes
  No
     Name of Clinic and Year of Visa Medical Examination

     What subclass did you apply for?

TRN/HAP I.D.

Passport Number

Country of Issue

Date of Issue
format:mm/dd/yyyy

Applicant's Details

Applicant's Name
Family Name

Given Name

Middle Name
Date of Birth
format:mm/dd/yyyy
Sex
Male Female
Civil Status
Contact Number
Email Address
Residential Address
Street

City

Province Postal Code
Do you intent to work as, or study to be, a doctor, dentist, nurse or paramedic during your stay in Australia? *
No Yes
For Temporary Visa: Do you intend to apply for a permanent stay in Australia within the next 6-12 months? *
No Yes