Migration Skills

Assessment

APPOINTMENT OF PERSON TO ACT AS AGENT

Office use only
CID

This form should be completed by an applicant who wishes to appoint a Migration Agent to act on their
behalf during the qualification assessment process and or any related secondary assessments. This
authorisation is necessary under Australian privacy legislation.
Completion of this form by the applicant provides the Agent with the Authority to:
Lodge applications on the applicants behalf
Deal with Engineers Australia on all aspects of the application including any previously submitted documents provided to Engineers Australia in
relation to any previous or future linked applications
Receive the final assessment outcome letter
Once an applicant has appointed an Agent, then all contact with Engineers Australia MUST be made via the Agent.

AUTHORISATION (PLEASE PRINT CLEARLY)

I, (applicants name)

of (address): 

City: Postcode:

State/Territory/District: Country:

Date of Birth:
DAY MONTH YEAR

authorise to the following person acting on my behalf in relation to my application for assessment.

Applicants Signature: Date:

DAY MONTH YEAR

MIGRATION AGENT'S DETAILS (PLEASE PRINT CLEARLY)

Note: All correspondence will be sent to the Agents email address as registered with Engineers Australia.
Agents EA ID (if applicable):

Agents Name:

Agents Address:

Agents Registration Number (if applicable):

Applicants EA ID: Agents Telephone Number:

APPLICANTS DECLARATION (CDR APPLICANTS ONLY)

All statements of fact in this report are true and correct, and I have made claims of acquired competencies in good faith.
The Report is all my own work, and is a true representation of my personal competencies in written English. I confirm that I understand that
members of the engineering team in Australia are required to display a commitment to exercising professional and ethical responsibility in
all aspects of their work.
I also understand that documentation submitted in support of my application may be referred to the Australian Department of Immigration
and Border Protection for integrity checking.

Printed Name:

Signature: Date:
DAY MONTH YEAR
Privacy Statement
The Institution of Engineers Australia trading as Engineers Australia ABN 63 020 415 510, collects, holds, uses and may disclose personal information in accordance with its Privacy
Policy and the Privacy Act 1988 (Cth). Engineers Australia collects this information so that it can provide products, services and support to you. If you do not provide certain personal
information in the course of submitting your application,Engineers Australia may be unable toprocess your application. Further information aboutEngineers Australias Privacy Policy
may be found at https:/engineersaustralia.org.au/systems-pages/privacy-statement