REGISTRATION FORM Please complete the below form to register your arrival in Western Australia Question Title * 1. Date Date Question Title * 2. Family name Question Title * 3. Given name Question Title * 4. State nomination reference number Question Title * 5. Visa subclass Question Title * 6. Passport nationality Question Title * 7. Nominated occupation Question Title * 8. Date of arrival in Western Australia Date Question Title * 9. Date of birth Date Postal address Question Title * 10. Street name and number Question Title * 11. Suburb Question Title * 12. Postcode Question Title * 13. State Question Title * 14. Mobile Question Title * 15. Email Question Title * 16. I would like to subscribe to the Migration Services newsletter Yes No As part of your signed Conditions of State Nomination you indicated that you expected to remain living and working in Western Australia for two years after being granted a visa.Please notify the Settlement Service team of any changes to your contact details, to ensure you can continue to participate in the post-arrival surveys.For further information on registration, please contact Settlement Services:E: settlementservices@dtwd.wa.gov.auT: +61 8 9224 6540 Done