REGISTRATION FORM Please complete the below form to register your arrival in Western Australia * 1. Date Date DD / MM / YYYY * 2. Family name * 3. Given name * 4. State nomination reference number * 5. Visa subclass * 6. Passport nationality * 7. Nominated occupation * 8. Date of arrival in Western Australia Date DD / MM / YYYY * 9. Date of birth Date DD / MM / YYYY Postal address * 10. Street name and number * 11. Suburb * 12. Postcode * 13. State * 14. Mobile * 15. Email 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
