Application Form for Malaysia’s

Work and Holiday Visa Program

Part A – Your details 7. Details from your passport

Passport number
1. Your full name, exactly as it appears on the passport on which you will
be traveling to Malaysia Country of passport
DAY MONTH YEAR
Family name Date of issue
Given names
Date of expiry

2. Have you been known by any others names? Issuing

(including name at birth, previous married names, aliases) authority/Place of
No Yes Give details issue as shown in
your passport

If you hold more than one passport please provide details of those
passports
3. Sex Male Female
Your full name as it appears in the passport
4. Date of birth Family name

5. Place of birth Given name

Town/city Passport number

Country Country of passport

DAY MONTH YEAR
6. Marital status Date of issue
Married Separated Widowed
Date of expiry
Engaged Divorced Never married
Issuing
De facto authority/Place of
issue as shown in
your passport

Note: Applicants must hold a valid passport in order to be granted

with an approval. It is recommended that the passport be valid for at
least 6 months.
If you change your passport after you have been granted the approval to
participate in this program, you must notify the nearest Malaysian mission. If
you do not provide the mission with the details of any new or additional
passport you use to travel to Malaysia, you will experience significant delays
at the airport and could be denied permission to board your plane.

8. Do you hold any citizenship other than that shown as your country of
passport above?
No Yes Give details

9. Details of identity card or identity number issued to you by your government

(if applicable) eg. National identity card.
Note: If you are the holder of multiple identity numbers because you are a
citizen of more than one country, you need to enter the identity number on
the card from the country that you live in.

Identity number

Country of issue

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10. Usual occupation 16. Do you agree to the department communication with you by fax,
e-mail, or other electronic means? (Providing an e-mail address will allow for
more efficient processing of your application)
No
11. What type of employment do you intend to seek during your stay?
Yes Give details

COUNTRY CODE AREA CODE NUMBER

Fax number ( ) ( )
12. Qualifications
E-mail address

Please ensure you have access to this e-mail while your application
is being processed
DAY MONTH YEAR
17. Date of proposed travel to Malaysia
13. Current residential address
Note: A post office box address is not acceptable as a residential Note: You must enter Malaysia within 3 months from the date the approval
address. Failure to give a residential address will result in your is granted.
application being invalid.
18. Do you have sufficient funds for the initial period of your stay in Malaysia?
Note: You may be asked to provide evidence (eg. Bank statement)
No Yes
POSTCODE
19. Do you have a return or onward ticket or the funds for a fare to depart
14. Address for correspondence
Malaysia?
(This may be required by the department to communicate with you
Note: You may be asked to provide evidence.
about your application. If the same as your residential address, write
‘AS ABOVE’) No Yes

20. Do you have any dependent children?

No Yes
POSTCODE
Part B – Previous applications
15. Your telephone numbers
21. Have you previously been to Malaysia, applied for a visa, held or currently
Mobile
COUNTRY CODE AREA CODE NUMBER hold a visa for travel to Malaysia.
Office hours ( ) ( ) No
Yes Give full details including type of visa(s), place(s) of
After hours ( ) ( ) application and date(s) of entry to Malaysia (if applicable)

22. Have you previously been detained in Malaysia, removed or deported from
Malaysia, or refused entry into Malaysia?
No
Yes Give full details

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23. Please provide the contact details of a relative, friend or a person you Part D – Health details
know in Malaysia
Relationship to you 26. Have you ever:

Family name • Been convicted of a crime or offence No Yes

Given names in any country (including any
conviction which is now removed
from official records)?
Address
• Been charged with any offence that No Yes
is currently awaiting legal action?
• Been acquitted of any criminal No Yes
POSTCODE offence or other offence on the
Telephone numbers grounds of mental illness, insanity or
Office hours (AREA CODE )
unsoundness of mind?
After hours (AREA CODE ) • Been removed or deported from any No Yes
country (including Malaysia)
Mobile
• Left any country to avoid being No Yes
removed or deported?
Part C – Health details
• Been refused a visa from other No Yes
24. In the last 5 years, have you visited or lived, for more than 3 countries?
consecutive months, outside the country of passport on which you will • Been excluded from or asked to No Yes
be traveling to Malaysia? leave any country (including
No Malaysia)?
• Committed, or been involved in the No Yes
Yes Give details commission of war crimes or crimes
1. Country against humanity or human rights?
DAY MONTH YEAR DAY MONTH YEAR • Been involved in any activities that No Yes
From to would represent a risk to Malaysian
national security?
2. Country • Had any outstanding debts to the No Yes
DAY MONTH YEAR DAY MONTH YEAR
Malaysian Government or any public
From to
authority in Malaysia?
• Been involved in any activity, or No Yes
3. Country
DAY MONTH YEAR DAY MONTH YEAR been convicted of any offence,
From to relating to the illegal movement of
people to any country (including
Malaysia)?
• Served in a military force or state No Yes
25. Do you hold health insurance to cover your stay in Malaysia? sponsored/private militia, undergone
any military/paramilitary training, or
No been trained in weapons/explosives
use (however described) other than
Yes in the course of compulsory military
service?

If you answered ‘Yes’ to any of the above questions you must give all
relevant details in the space provided below.

If the matter relates to a criminal conviction, please give the nature of the
offence, full details of sentence, dates of any of imprisonment or other
detention and a personal account of the events leading up to and including
the offence (s)

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 Part E – Declaration

27. Please sign the declaration below

I declare that:
All of the information given in this form is correct.
If my application is approved by the Malaysia’n Government, I will
respect Malaysian values during my stay in Malaysia and will obey the
laws of Malaysia.
Signature of
applicant

DAY MONTH YEAR

Date

Please check all questions are answered. If you form is incomplete,

there may be delays in processing your application.

We strongly advise that you keep a copy of your application and all
attachments for your records.

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 Applicant for a Work and Holiday visa

Life in Australia – Australian values A Work and Holiday visa allows the visa holder to:

The Australian Government encourages people to gain an • Enter Australia within 3 months of the date of visa grant;
understanding of Australia, its people and their way of life, before • Stay in Australia for up to 12 months;
applying for a visa to live in Australia. As part of this application every • Leave and re-enter Australia any number of time while the visa is
person aged 18 years or over must declare that they will respect valid;
Australian values, as outlined below and obey the laws of Australia. • Work in Australia for up to 6 months with each employer; and
• Study for up to 4 months
Australian values include respect include respect for the freedom and
dignity of the individual, freedom of religion, commitment to the rule of Arrangement countries
law, Parliamentary democracy, equality of men and women and a spirit
of egalitananism that embraces mutual respect, tolerances, fair play Australia currently has reciprocal Work and Holiday arrangements
and compassion for those in need and pursuit of the public good. with:
• Chile;
Australian society also values equality of opportunity for individuals, • Thailand;
regardless of their race, religion or ethnic background.
• Turkey; and
• The USA
It is also important to understand that English is the national language.
Note: There is an annual limit to the number of visas that may be
Further information is contained in the Life in Australia booklet,
issued to applicants from:
however, you are not required to read the booklet. The booklet is
available in a wide range of languages. If you would like a copy of the
booklet it can be obtained from www.immi.gov.au • Chile;
• Thailand; and
About this form • Turkey

Important-Please read this information carefully before you complete If the limit has been reached, applicants will be notified and the
your application. Once you have completed your application we processing of their application may be delayed.
strongly advise that you keep a copy for your records.
Australia continues to negotiate Work and Holiday arrangements with
Note: Any reference in this form to ‘country’ refers to ‘foreign country’ additional countries. To see whether any arrangements have been
which is defined in paragraph 22(1)(f) of the Acts Interpretation Act established with additional countries, check the department’s website
1901 as any country (whether or not an independent sovereign state) www.immi.gov.au/visitors/
outside Australia and the external Territories.
Eligibility requirements
Who should use this application
To be granted a visa, there are a number of eligibility requirements
Applicants applying for a Work and Holiday (subclass 462) visa. Each that applicants must meet.
applicant must apply individually and cannot include family members in
their application. All applicants must:
• Be aged between 18 years and 30 years inclusive (at the time you
Online applications apply);
• Hold a passport from an eligible country, preferably valid for at
Applicants from the United States of America (USA) may apply on the least 6 months;
Department of Immigration and Citizenship (the department) website. • Have functional English; and
Payment must be made by credit card for online applications. Further • Meet education requirements as follows:
information is available from the department’s website
www.immi.gov.au/visitors/ Passport Education requirement
country
If you wish to apply online do not use this applicant. Chile Tertiary qualifications or
have completed/been
Visa overview approved to undertake a
third year of undergraduate
The Work and Holiday visa Program encourages cultural exchange university study
and closer ties between arrangement countries by allowing young Thailand Degree or post high school
people to have an extended holiday supplemented by short-term diploma from an accredited
employment. institution
Turkey Tertiary qualifications, or
have successfully completed
at least 2 years of
undergraduate university,
study
USA High school graduate

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 • not be accompanied by dependent children; Step 3
• be outside Australia when you apply and when the visa is
granted Lodge your completed application and required attachments (see
• not have entered Australia on a Work and Holiday (subclass Application checklist on page 4 of this application)as outlined below.
462) or Working Holiday (subclass 417) visa;
• have sufficient funds (generally AUD5,000); Applicants from the USA can lodge their application by post, fax or
• have funds for a return or onward ticket to depart Australia (or hand delivering this application to any Australian Immigration office
an actual ticket); overseas. More information is available from
• have health insurance (recommended) covering your stay in www.immi.gov.au/contacts/overseas. Applicants from Chile,
Australia. This can be contained in your home country or in Thailand and Turkey can lodge their application by post, fax or hand
Australia. More information is available from delivering this application to the Australian Immigration office in their
www.immi.gov.au/allforms/health; and country of passport.
• meet Australia’s character requirement. More information is
available from www.immi.gov.au/allforms/character Do not send cash or your passport with your application

Applicants from Chile, Thailand and Turkey must also: What happens next?

Your application will be assessed. You may be asked to provide

• provide a letter of approval from your government agreeing to
additional information to enable a decision to be made. You will be
your stay in visa under the Work and Holiday visa
advised in writing whether your application has been approved. If your
arrangement (the letter of support does not guarantee a place
application is refused, you will be given reasons for the decision.
in the Work and Holiday program); and
• provide proof of English proficiency.
You should do not make any irreversible travel arrangements
until you receive written advice of the departments decision on
How much does the visa cost?
your application.
Payment must accompany your application and is generally not
Note: If you are granted an Electronic travel Authority (ETA) or
refunded if the application is unsuccessful. To check the Visa
Maritime Crew Visa (MCV) as well as a Work and Holiday Visa, you
Application Charge, see form 990i Charges available from the
will activate the Work and Holiday visa on arrival in Malaysia, rather
department’s website www.immi.gov.au/allforms/990i.htm or
than the ETA or MCV. This will activate the 12 month stay period of
check with the nearest office of the department.
the Work and Holiday visa, which will not be able to be postponed or
deferred. If you want to travel on the ETA or MCA, you must have your
Method of payment
Work and Holiday visa cancelled before traveling to Australia. You will
be able to apply for a Work and Holiday visa in the future, provided
Outside Australia
you meet the eligibility requirements.
Before making a payment outside Australia, please check with the
Important-change of personal/passport details
Australian Government office where you intend to lodge your
application as to what methods of payment and currencies they
If you wish to change any details after you lodge your application,
can accept and to whom the payment should be made payable.
including your passport details, or if you wish to withdraw the
application, please contact the department:
How To Apply
• Applicants from Chile, Thailand and Turkey-contact the
Step 1
Australian Immigration office overseas where you lodge d
your application. More information is available from
Complete this application
www.immi.gov.au/contacts/overseas/
Please use a pen, and write neatly in English using BLOCKS • Applicants from the USA-E-mail
LETTERS [email protected]

You must provide the address where you intend to live while your Your Work and Holiday visa application is linked to the passport
application is being processed. Failure to give a residential number provided in your application. If you are granted a visa, but
address in your application will result in your application being do not provide the department with the details of any new
passport you use to travel to Australia, you will experience
invalid. A post office box address will not be accepted as your
residential address. significant delays at the airport and could be denied permission
to board your plane.
Step 2
Option for receiving written communications
Contact the Australian Government office in the country which
issued your passport to confirm application arrangements (eg. You may authorize another person to receive all communications, both
Whether there are any additional local requirements). More written and electronic, about your application with the department. You
information is available from will be taken to have received any documents sent to that person as if
www.immi.gov.au/contracts/overseas they had been sent to you.

To do this you will need to complete Part F Options for receiving

written communications and form 956 Appointment of a migration
agent or exempt agent or other authorized recipient. For an
explanation of what a migration agent or exempt agent or authorized
recipient can do please read the sections on page 3.

To change or end the appointment of your migration agent or exempt Exempt agents

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agent or authorized recipient you must promptly advise the department
in writing. You can do this by using form 956 Appointment of a The following people do not have to be a registered migration agent in
migration agent or exempt agent or other authorized recipient. order to provide immigration assistance, but they must not charge a
fee for their service:
Authorised recipient information • A close family member (spouse, child, adopted child, parent,
brother or sister);
An authorized recipient is someone you appoint to receive written • A sponsor or nominator for this visa application;
communications about your application with the department. • A member or parliament or their staff;
• An official whose duties include providing immigration assistance
All written communication about your application will be sent to your (eg. A Legal Aid provider);
authorized recipient, unless you indicate that you wish to have health • A member of a diplomatic mission, consular post or international
and/or character information sent directly to you. organization.
The department will communicate with the most recently appointed
authorized recipient as you may only appoint one authorized recipient Further information on migration agents
at any time for a particular application.
Information on migrants agents, including a list of registered migration
Migration age information agents, is available on the Migration Agents Registration Authority
(MARA) website www.themara.com.au
A migration agent is someone who can: You can also access information about migration agents on the
• Advise you on the visa that may best suit you; department’s website www.immi.gov.au
• Tell you the documents you need to submit with your application;
• Help you fill in the application and submit it; and Consent to communicate electronically
• Communicate with the department on your behalf.
The department may use a range of means to communicate with you.
If you appoint a migration agent, the department will assume that your However, electronic means such as fax or e-mail will only be used if
migration agent will be your authorized recipient, unless you indicate you indicate your agreement to receiving communication in this way.
otherwise.
To process your application the department may need to communicate
Your migration agent will be the person with whom the department will with you about sensitive information, for example, health, police
discuss your application and from whom it will seek further information checks, financial viability and personal relationship. Electronic
when required. communication, unless adequately encrypted, are not secure and may
You are not required to use a migration agent. However, if you use a be viewed by others or interfered with. If you agree to the department
migration agent, the department encourages you to use a registered communicating with you by electronic means, the details you provide
migration agent. Registered agents are bound by the Migration Agents will only be used by the department for the purpose for which you have
Code of Conduct, which requires them to act professionally in their provided them, unless there is a legal obligation for which you have
client’s lawful best interest. provided them, unless there is a legal obligation or necessity to use
them for another purpose, or you have consented to use for another
Immigration assistance purpose.

A person gives immigration assistance to you if he or she uses, or The Australian Government accepts no responsibility for the security
claims to use, his or her knowledge or experience in migration or integrity of any information sent to th department over the internet or
procedure to assist you with your application, request for ministerial by other electronic means.
intervention, cancellation review application, sponsorship or
nomination. About the information you give in this form
In Australia a person may only lawfully give immigration assistance if
he or she is a registered migration agent or is exempt from being The department is authorized to collect information provided on this for
registered. Only registered migration agents may receive a fee or under Part 2 of the Migration Act 1958 ‘Control of Arrival and Presence
reward for providing immigration assistance. of Non-Citizens’. The information provided will be used for assessing
your eligibility for a visa to visit Australia.
If an unregistered person in Australia, who is not exempt from The information provided might also be disclosed to agencies who are
registration, gives you immigration assistance they are committing a authorized to receive information relating to adoption, border control,
criminal offence and may be prosecuted. business skills, citizenship, education, health assessment, health
insurance, health service, law enforcement, payment of pensions and
Migration agents in Australia benefits, taxation, review of decisions and registration of migration
agents.
Migration agents in Australia must be registered with the Migration Relevant information about you will be disclosed to federal, state and
Agents Registration Authority (MARA) unless they are exempt from territory police to assist in your location and possible detention in the
registration. event that you become an unlawful non-citizen.

Migration agents outside Australia You will become an unlawful non-citizen if your visa cases (by
cancellation for breach of visa condition for example) or expires and
Migration agents who operate outside Australia do not have to be you do not hold another visa authorizing you to remain in Australia.
registered. The department may give some overseas agents an ID
number. This number does not mean that they are registered.

Note: Some Australian registered migration agents operate overseas.

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The collection, access, storage, use and disclosure by the department Application Checklist
of the information you provide in this form is governed by the Privacy
Act 1988 and, in particular, by the 11 information Privacy Principles. This checklist is provided for your assistance and lists the required and
The information from 9931 Safeguarding your personal information, optional documents to include with your application. It is not a
available from offices of the department, gives details of agencies to requirement of your application.
which your personal information might be disclosed.
Note: Processing of your application will be delayed if you do not
The information provided on this form, including any information on provide all the required information and documents at the time of
your health, will be used to assess your health for an Australian visa lodgment.
and may be disclosed to the relevant Commonwealth, state and
territory health agencies and examining doctor (s). Note: Certified copies are copies authorized, or stamped as being true
copies or originals, by a person or agency recognized by the law of the
Form 1163i Health Requirement for temporary entry to Australia country in which you currently reside.
provides additional information on Australia’s visa health requirements.
This form is available at offices of the department or from the Note: If your documents are in a language other than English,
department’s website www.immi.gov.au/allforms/ translations into English must be provided.

The department has authority under the Migration Act 1958 to collect a TICK
when completed.
range of personal identifiers from non-citizens, including visa
applicants, in certain circumstances. For more detailed information you
should read information form 1243i Your personal identifying A certified copy of the pages of your passport
information, which is available from the department’s website containing your photo and personal details
www.immi.gov.au/allforms/ (Note: Your passport preferably should be valid
for at least 6 months).

The Visa Application Charge (for the current

Working and Holiday Visa Application Charge,
see form 990i Charges, available from
www.immi.gov.au/allforms/pdf/990i.pdf)

For payment options, see Method of payment on

page 2 this application.

If you are authorizing another person to act and

receive communications on your behalf,
complete Part F Options for receiving written
communications on page 8 and form 956
Appointment of a migration agent or exempt
agent or other authorised recipient.

If you are from:

• Chile;
• Thailand; or
• Turkey; an original letter of approval
from your government.

If you are from

• Chile;
• Thailand; or
• Turkey; proof of English proficiency.