Information of Sri Lankans affected due to COVID -19 Pandemic in Australia
Please submit separate form for each family member
1.1 Surname: (As appeared in the passport)(Please submit separate form for each family member) *
1.2 Other names : (As appeared in the passport)
2. Passport Number: *
3. Age: *
4. Gender *
5. If accompanied by family, their details (Information on dependants if accompanied)
6. No. of persons with dependants (If accompanied)
7. Residential Address in Sri Lanka with contact Numbers : *
8. Residential Address in Australia : *
9. Residence state in Australia * *
10. Contact Number: *
11. Email Address: *
11. Next of Kin (immediate relative) to be contacted in an emergency (address, phone, email ) : *
12. Category (Tourists , Short term visa holders, ,Student, workers (specify your job i.e. unskilled, skilled, professionals) , , visiting for business purposes, *
13. Do you have an already purchased Ticket to Sri Lanka? *
14. If Yes,Name of the Airline:
15. If Transit, Transit City:
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