Please note that all fields followed by an asterisk must be filled in.
First Name*
First Name*
Last Name*
Last Name*
Zip/Postal Code*
Zip/Postal Code*
Country*
Country*
Country United States Canada —————- Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribadi North Korea South Korea Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Former Republic of Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Federated States of Micronesia Moldova Monaco Mongolia Monserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Island Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda S. Georgia and S. Sandwich Isls. Saint Kitts and Nevis Saint Lucia Saint Vincent and The Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka St. Helena St. Pierre and Miquelon Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu U.S. Minor Outlying Islands Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam US VIrgin Islands Wallis and Futuna Islands Western Sahara Yemen Yugoslavia (former) Zaire Zambia Zimbabwe
E-mail Address*
E-mail Address*
Repeat E-mail Address*
Repeat E-mail Address*
At what stage are you in the migration process?*
At what stage are you in the migration process?*
—Select— a) Doing initial research b) In the process of submitting application. c) Application has been lodged d) Application approved e) Medicals & Police checks complete f) Visa Stamped g) Ready to fly to Perth h) N/A
Will you be flying to Perth first to get your Visa Stamped? If yes when will this?*
Will you be flying to Perth first to get your Visa Stamped? If yes when will this?*
—Select— a) Within the next six months b) Between six and nine months c) Between nine and twelve months d) N/A
What type of short-term accommodation will you be looking to stay in?*
What type of short-term accommodation will you be looking to stay in?*
—Select— a) Holiday Rental b) Hotel c) Apartment Hotel d) B&B e) Other f) Don’t Know g) N/A
Would you be interested in assistance making the booking?*
Would you be interested in assistance making the booking?*
—Select— a) Yes b) No
What type of long-term accommodation will you be looking for?*
What type of long-term accommodation will you be looking for?*
—Select— a) Rental Property b) Buy a property c) Build a property d) Other e) N/A
Would you be interested in assistance finding any of the above?*
Would you be interested in assistance finding any of the above?*
—Select— a) Yes b) No
Will you be interested in assistance booking your car hire?*
Will you be interested in assistance booking your car hire?*
—Select— a) Yes b) No
Will you be looking to purchase a Car?*
Will you be looking to purchase a Car?*
—Select— a) Yes b) No
Would you be interested in an Orientation of Perth and suburbs (tailored to meet your needs)?*
Would you be interested in an Orientation of Perth and suburbs (tailored to meet your needs)?*
—Select— a) Yes b) No c) N/A
When will you be making your permanent move to Perth?*
When will you be making your permanent move to Perth?*
—Select— a) Within the next six months b) Between six and nine months c) Between nine and twelve months d) Longer e) N/A
Do you know where in Perth you want to live?*
Do you know where in Perth you want to live?*
—Select— a) Yes will be living in Perth suburb b) Yes will be living in Regional Perth (WA) location c) No but it will be a Perth Suburb d) No but it will be a regional Perth (WA) location
Would you be interested in assistance finding the most suitable Suburb to suit your lifestyle and budget before you arrive in Perth?*
Would you be interested in assistance finding the most suitable Suburb to suit your lifestyle and budget before you arrive in Perth?*
—Select— a) Yes b) No c) Not sure please send me more information when it is available
Would you like assistance finding your New Home when you arrive in Perth?*
Would you like assistance finding your New Home when you arrive in Perth?*
—Select— a) Yes b) No
Would you like assistance finding work?*
Would you like assistance finding work?*
—Select— a) Yes b) No
Is there any other information you would like to see on ImmigratePerth.com?
