This form contains 296 fields organized into 60 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Aboriginal or Torres Strait Islander Status
DummyCalcQ4 Text
No Checkbox
Check this box if you are not an Australian Aboriginal or Torres Strait Islander person.
Yes - Aboriginal Checkbox
Check this box if you identify as an Australian Aboriginal person.
Yes - Torres Strait Islander Checkbox
Check this box if you identify as a Torres Strait Islander person.
ABSTUDY Pensioner Education Supplement Eligibility
No Checkbox
Check this box if you were NOT receiving ABSTUDY Pensioner Education Supplement while on Parenting Payment Single or Disability Support Pension. Fill only if 'Before the grant of your JobSeeker Payment or Youth Allowance (job seeker), were you receiving Parenting Payment Single or Disability Support Pension?' is 'Yes'.
Depends on: Yes, was receiving previous benefit
Yes Checkbox
Check this box if you WERE receiving ABSTUDY Pensioner Education Supplement while on Parenting Payment Single or Disability Support Pension. Fill only if 'Before the grant of your JobSeeker Payment or Youth Allowance (job seeker), were you receiving Parenting Payment Single or Disability Support Pension?' is 'Yes'.
Depends on: Yes, was receiving previous benefit
Address while studying
Address Line 1 Text
Provide the first line of your address while studying, including street number and street name. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Address Line 2 Text
Provide the second line of your address while studying, including suburb or city and state. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Postcode Text
Provide the postcode for your address while studying. Fill only if 'Yes' is 'Yes'.
Max length: 4 characters
Depends on: Yes
Authorisation to act on your behalf
No Checkbox
Check this box if you do not want to authorise a person or organisation to make enquiries, updates, act, or get payments on your behalf.
Yes Checkbox
Check this box if you want to authorise a person or organisation to make enquiries, updates, act, or get payments on your behalf.
Centrelink/Veterans' Affairs Payment Details
No Checkbox
Check this box if you are not currently getting, and will not get, a Centrelink pension, benefit, payment, or allowance, or a pension from the Department of Veterans' Affairs.
Yes Checkbox
Check this box if you are currently getting, or will get, a Centrelink pension, benefit, payment, or allowance, or a pension from the Department of Veterans' Affairs.
Payment Type Text
Enter the type or category of the Centrelink or Veterans' Affairs payment. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Payment Name Text
Enter the full name of the Centrelink or Veterans' Affairs pension, benefit, payment, or allowance. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
CRN Segment 1 Text
Enter the first segment of your Customer Reference Number, if known. Fill only if 'Yes' is 'Yes'.
Max length: 3 characters
Depends on: Yes
CRN Segment 2 Text
Enter the second segment of your Customer Reference Number, if known. Fill only if 'Yes' is 'Yes'.
Max length: 3 characters
Depends on: Yes
CRN Segment 3 Text
Enter the third segment of your Customer Reference Number, if known. Fill only if 'Yes' is 'Yes'.
Max length: 3 characters
Depends on: Yes
CRN Segment 4 Text
Enter the fourth segment of your Customer Reference Number, if known. Fill only if 'Yes' is 'Yes'.
Max length: 1 characters
Depends on: Yes
Veterans' Affairs Reference Number Text
Enter your Veterans' Affairs Reference Number, if known. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Payment Date Day Number
Provide the day of the payment date. Fill only if 'Yes' is 'Yes'.
Max length: 2 characters
Depends on: Yes
Payment Date Month Number
Provide the month of the payment date. Fill only if 'Yes' is 'Yes'.
Max length: 2 characters
Depends on: Yes
Payment Date Year Number
Provide the year of the payment date. Fill only if 'Yes' is 'Yes'.
Max length: 4 characters
Depends on: Yes
Checklist of Provided Documents
Copy of documents with details of a cadetship/scholarship Checkbox
Check this box if you are providing a copy of documents with details of a cadetship or scholarship, and it is required at question 11. Fill only if 'Do you, or will you, receive other government assistance for study or training?' is 'A cadetship/scholarship'.
Depends on: Cadetship/scholarship
Copy of statement with reasons for break in study Checkbox
Check this box if you are providing a copy of a statement with reasons for a break in study, and it is required at question 22. Fill only if 'Are you returning to study after a break of more than one semester?' is 'Yes'.
Depends on: Yes
Copy of proof of enrolment in current study Checkbox
Check this box if you are providing a copy of proof of enrolment in your current study, and it is required at question 23.
Copy of proof of full-time study Checkbox
Check this box if you are providing a copy of proof of full-time study, and you answered Yes at question 25. Fill only if 'Are you, or will you be, studying externally by distance education or correspondence?' is 'Yes'.
Depends on: Yes
Copy of proof of Startup Year course enrollment and STARTUP-HELP loan selection Checkbox
Check this box if you are providing a copy of proof that you are enrolled in the Startup Year course and have been selected for a STARTUP-HELP loan, and you answered Yes at question 27. Fill only if 'Are you studying a Startup Year course?' is 'Yes'.
Depends on: Yes
Copy of statement with a list of your subjects (Question 28) Checkbox
Check this box if you are providing a copy of a statement with a list of your subjects, and you answered Not sure at question 28. Fill only if 'Are you a full-time secondary school student, including a student enrolled in a secondary distance education institution?' is 'Not sure'.
Depends on: Not sure
Copy of statement from school about being a part-time student Checkbox
Check this box if you are providing a copy of a statement from your school about being a part-time student, and you answered question 29. Fill only if you answered question 29.
Depends on: 75 - 100%, 66 - 74%, 50 - 65%, 25 - 49%, 0 - 24%, Not sure, 75 - 100%, 66 - 74%, 50 - 65%, 25 - 49%, 0 - 24%, Not sure
Copy of statement with a list of your subjects (Question 29) Checkbox
Check this box if you are providing a copy of a statement with a list of your subjects, and you answered Not sure at question 29. Fill only if 'Percentage of the full-time study load in your course' is 'Not sure'.
Depends on: Not sure, Not sure
Copy of details of dependent children travelling with you Checkbox
Check this box if you are providing a copy of details of dependent children travelling with you, and you answered Yes at question 34. Fill only if 'Will you have dependent children travelling with you?' is 'Yes'.
Depends on: Yes
Copy of statement with dates you will be living in residence Checkbox
Check this box if you are providing a copy of a statement with dates you will be living in residence, and you answered Yes and if known at question 35. Fill only if 'Do you want your residential costs paid instead of getting the Pensioner Education Supplement while you are living in a residential college or hostel?' is 'Yes'.
Depends on: Yes
Authorising a person or organisation to enquire or act on your behalf (SS313) form Checkbox
Check this box if you are providing an SS313 form authorising a person or organisation to enquire or act on your behalf, and you answered Yes at question 36. Fill only if 'Do you want to authorise a person or organisation to make enquires, make updates, act and/or get payments on your behalf?' is 'Yes'.
Depends on: Yes
Q38 Text
Max length: 1 characters
Citizenship Details
No Checkbox
Check this box if you are not an Australian citizen.
Yes Checkbox
Check this box if you are an Australian citizen.
Country of Birth Text
Please provide the country where you were born.
Place of Birth Text
Please provide the city or town where you were born.
Day of Citizenship Text
Please provide the day you became a citizen. Fill only if 'Place of Birth' is not 'Australia'.
Max length: 2 characters
Depends on: Place of Birth
Month of Citizenship Text
Please provide the month you became a citizen. Fill only if 'Place of Birth' is not 'Australia'.
Max length: 2 characters
Depends on: Place of Birth
Year of Citizenship Text
Please provide the year you became a citizen. Fill only if 'Place of Birth' is not 'Australia'.
Max length: 4 characters
Depends on: Place of Birth
Contact Details
Home Phone Number Text
Please enter your home phone number, including the area code.
Max length: 10 characters
Mobile Phone Number Text
Please enter your mobile phone number.
Max length: 10 characters
Semester/Term Phone Number Text
Please enter your phone number for the semester or term, including the area code. Fill only if 'Yes' is 'Yes'.
Max length: 10 characters
Depends on: Yes
Work Phone Number Text
Please enter your work phone number, including the area code.
Max length: 10 characters
Alternative Phone Number Text
Please enter an alternative phone number, including the area code.
Max length: 10 characters
Email Address Text
Please enter your email address.
Date of Birth
Day of Birth Date
Please provide the day of your birth. Fill only if 'Are you getting JobSeeker Payment or Youth Allowance (job seeker)?' is 'No'.
Max length: 2 characters
Depends on: No
Month of Birth Date
Please provide the month of your birth. Fill only if 'Are you getting JobSeeker Payment or Youth Allowance (job seeker)?' is 'No'.
Max length: 2 characters
Depends on: No
Year of Birth Date
Please provide the year of your birth. Fill only if 'Are you getting JobSeeker Payment or Youth Allowance (job seeker)?' is 'No'.
Max length: 4 characters
Depends on: No
Declaration Agreement
I have read, understood and agree to the above. Checkbox
Check this box to confirm that you have read, understood, and agree to the declarations and understandings outlined in Part H of the form.
Declaration Date
Declaration Day Text
Please enter the day of the declaration date (e.g., 01 for the 1st). Fill only if 'I have read, understood and agree to the above.' is checked.
Max length: 2 characters
Depends on: I have read, understood and agree to the above.
Declaration Month Text
Please enter the month of the declaration date (e.g., 01 for January). Fill only if 'I have read, understood and agree to the above.' is checked.
Max length: 2 characters
Depends on: I have read, understood and agree to the above.
Declaration Year Number
Please enter the year of the declaration date (e.g., 2023). Fill only if 'I have read, understood and agree to the above.' is checked.
Max length: 4 characters
Depends on: I have read, understood and agree to the above.
Dependent children travelling with you
No Checkbox
The user should check this box if they will not have dependent children travelling with them.
Yes Checkbox
The user should check this box if they will have dependent children travelling with them.
External Study Status
No Checkbox
Check this box if you are not studying externally by distance education or correspondence.
Yes Checkbox
Check this box if you are studying externally by distance education or correspondence.
First Completed Course
First Course Institution Name Text
Please provide the name of the institution or campus where you completed your first course. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
First Course Name Text
Please provide the full name of the first course you completed. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
First Current Course Study Year
Current Study Year Text
Please provide the year this current course of study began. Fill only if 'Yes' is 'Yes'.
Max length: 4 characters
Depends on: Yes
Current Study Year Stage Text
Please provide the year or stage of study for this current course. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Current Course Institution Name Text
Please provide the full name of the institution where you are currently studying. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Current Course Name Text
Please provide the full name of the current course you are undertaking. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Full-time (Semester 1) Checkbox
Check this box if the study for Semester 1 of the first current course year was full-time. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Part-time (Semester 1) Checkbox
Check this box if the study for Semester 1 of the first current course year was part-time. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Full-time (Semester 2) Checkbox
Check this box if the study for Semester 2 of the first current course year was full-time. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Part-time (Semester 2) Checkbox
Check this box if the study for Semester 2 of the first current course year was part-time. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
First date living in residence
Day (first digit) Text
Enter the first digit of the day you will begin living in residence. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Day (second digit) Text
Enter the second digit of the day you will begin living in residence. Fill only if 'Yes' is 'Yes'.
Max length: 2 characters
Depends on: Yes
Month Text
Enter the month you will begin living in residence. Fill only if 'Yes' is 'Yes'.
Max length: 2 characters
Depends on: Yes
Year Text
Enter the year you will begin living in residence. Fill only if 'Yes' is 'Yes'.
Max length: 4 characters
Depends on: Yes
Date not yet known Checkbox
Check this box if you do not yet know the exact dates you will be living in residence. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
First Education Institution/Course
Institution Name Text
Provide the full name of the school, Australian college, or campus where you are studying.
Student ID Number Text
Enter your unique student identification number issued by the institution.
Course Title Text
Enter the exact title of the course you are undertaking, for example, 'School Studies' or 'Bachelor of Arts'.
Course Code Text
Provide the official code assigned to your course.
Course Year/Stage Text
Specify the current year or stage of your course, for instance, 'Year 11', '1st year', or 'B.Sc. Stage 2'.
Study Start Date Day Date
Enter the day the course officially started.
Max length: 2 characters
Study Start Date Month Date
Enter the month the course officially started.
Max length: 2 characters
Study Start Date Year Date
Enter the year the course officially started.
Max length: 4 characters
Study End Date Day Date
Enter the day the course is expected to finish.
Max length: 2 characters
Study End Date Month Date
Enter the month the course is expected to finish.
Max length: 2 characters
Study End Date Year Date
Enter the year the course is expected to finish.
Max length: 4 characters
Course Official Start Date Day Date
Enter the official day of the full course period's commencement.
Max length: 2 characters
Course Official Start Date Month Date
Enter the official month of the full course period's commencement.
Max length: 2 characters
Course Official Start Date Year Date
Enter the official year of the full course period's commencement.
Max length: 4 characters
Course Official End Date Day Date
Enter the official day of the full course period's completion.
Max length: 2 characters
Course Official End Date Month Date
Enter the official month of the full course period's completion.
Max length: 2 characters
Course Official End Date Year Date
Enter the official year of the full course period's completion.
Max length: 4 characters
First Other Course Study Year
Study Year Text
Please provide the year of study for this other course. Fill only if 'Yes' is 'Yes'.
Max length: 4 characters
Depends on: Yes
Study Year Stage Text
Please provide the stage or year of study for this other course (e.g., 1st year, 2nd year). Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Institution Name Text
Please enter the name of the institution where this other course was undertaken. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Course Name Text
Please enter the full name of this other course. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Semester 1 Full-time Checkbox
Check this box if the first other course was studied full-time during Semester 1 of that year. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Semester 1 Part-time Checkbox
Check this box if the first other course was studied part-time during Semester 1 of that year. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Semester 2 Full-time Checkbox
Check this box if the first other course was studied full-time during Semester 2 of that year. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Semester 2 Part-time Checkbox
Check this box if the first other course was studied part-time during Semester 2 of that year. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
First Other Name
Other Name Text
Please provide the other name you have been known by. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Type of Other Name Text
Please specify the type of other name, for example, name at birth or previous married name. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Flexible Learning Enrolment Status
No Checkbox
Check this box if you are not doing your course through flexible learning or study at your own pace enrolment.
Yes Checkbox
Check this box if you are doing your course through flexible learning or study at your own pace enrolment.
Fourth Completed Course
Fourth Course Institution Name Text
Please enter the name of the institution or campus where you completed your fourth course. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Fourth Course Name Text
Please enter the full name of the fourth course you completed. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Fourth Other Course Study Year
Year of Study Text
Enter the year this other course study commenced or was completed. Fill only if 'Yes' is 'Yes'.
Max length: 4 characters
Depends on: Yes
Year/Stage of Study Text
Enter the academic year or stage reached in this other course study. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Name of Institution Text
Enter the full name of the institution where this other course study was undertaken. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Name of Course Text
Enter the full name of this other course study. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Semester 1 Full-time Checkbox
Check this box if the fourth other course of study was full-time during Semester 1. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Semester 1 Part-time Checkbox
Check this box if the fourth other course of study was part-time during Semester 1. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Semester 2 Full-time Checkbox
Check this box if the fourth other course of study was full-time during Semester 2. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Semester 2 Part-time Checkbox
Check this box if the fourth other course of study was part-time during Semester 2. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Gender
Male Checkbox
Check this box if your gender is male. Fill only if 'Are you getting JobSeeker Payment or Youth Allowance (job seeker)?' is 'No'.
Depends on: No
Female Checkbox
Check this box if your gender is female. Fill only if 'Are you getting JobSeeker Payment or Youth Allowance (job seeker)?' is 'No'.
Depends on: No
Non-binary Checkbox
Check this box if your gender is non-binary. Fill only if 'Are you getting JobSeeker Payment or Youth Allowance (job seeker)?' is 'No'.
Depends on: No
General
Instructions Button
Q1GoToQ4 Button
Q7GoToQ11 Button
Q16_Address1 Text
Q16_Address2 Text
Q21GoToQ23 Button
Q27GoToQ29 Button
Q28GoToQ30 Button
Q28GoToQ32 Button
Q32GoToQ36 Button
Q33.Address1 Text
Q33.Address2 Text
Clear button Button
Interpreter Requirement
No Checkbox
Check this box if you do not need an interpreter.
Interpreter Language Text
Please specify the language of the interpreter you require, such as Auslan or another sign language, or a specific spoken language.
Yes Checkbox
Check this box if you need an interpreter.
JobSeeker/Youth Allowance Status
No Checkbox
Check this box if you are not currently receiving JobSeeker Payment or Youth Allowance (job seeker).
Job Seeker Status Text
Please enter your current Job Seeker status related to your JobSeeker Payment or Youth Allowance.
Yes Checkbox
Check this box if you are currently receiving JobSeeker Payment or Youth Allowance (job seeker).
Last Day of Study
Day of Last Study Text
Please enter the day of your last day of study. Fill only if 'No' is 'No'.
Max length: 2 characters
Depends on: No
Month of Last Study Text
Please enter the month of your last day of study. Fill only if 'No' is 'No'.
Max length: 2 characters
Depends on: No
Year of Last Study Text
Please enter the year of your last day of study. Fill only if 'No' is 'No'.
Max length: 4 characters
Depends on: No
Living away from home to study
No Checkbox
Check this box if you will not be living away from home to study.
Fares Allowance Reference Text
Please provide any relevant reference number or details regarding the approval of Fares Allowance, as mentioned in the notes. Fill only if 'Do you, or will you, receive other government assistance for study or training?' is 'Yes'.
Depends on: Yes
Yes Checkbox
Check this box if you will be living away from home to study.
Non-school Study Declaration
No Checkbox
Check this box if you have not started or completed any other non-school study related to the course you are currently doing. Fill only if 'Have you completed an undergraduate or postgraduate degree course?' is 'No'.
Depends on: No
Yes Checkbox
Check this box if you have started or completed other non-school study related to the course you are currently doing and need to provide details. Fill only if 'Have you completed an undergraduate or postgraduate degree course?' is 'No'.
Depends on: No
Other Government Assistance Confirmation
No Checkbox
Check this box if you do not currently receive, nor will you receive, any other government assistance for study or training. Fill only if 'Are you getting JobSeeker Payment or Youth Allowance (job seeker)?' is 'No'.
Depends on: No
Yes Checkbox
Check this box if you currently receive, or will receive, other government assistance for study or training. Fill only if 'Are you getting JobSeeker Payment or Youth Allowance (job seeker)?' is 'No'.
Depends on: No
Other Government Assistance Details
Payment Applies Code Text
Please enter the code that identifies which other government assistance payment applies to you. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Full-time apprenticeship/traineeship Checkbox
Check this box if you currently receive, or will receive, government assistance for a full-time apprenticeship or traineeship. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Cadetship/scholarship Checkbox
Check this box if you currently receive, or will receive, government assistance for a cadetship or scholarship. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Veterans' Children Education Scheme Checkbox
Check this box if you currently receive, or will receive, government assistance through the Veterans' Children Education Scheme. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Assistance for Isolated Children (AIC) Checkbox
Check this box if you currently receive, or will receive, government assistance through the Assistance for Isolated Children (AIC) scheme. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Youth Allowance Checkbox
Check this box if you currently receive, or will receive, government assistance through Youth Allowance. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Austudy Checkbox
Check this box if you currently receive, or will receive, government assistance through Austudy. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Living away from Home Allowance for an Australian Apprenticeship Checkbox
Check this box if you currently receive, or will receive, government assistance through the Living away from Home Allowance for an Australian Apprenticeship. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Any other assistance Checkbox
Check this box if you currently receive, or will receive, any other government assistance for study or training not listed above. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Details of Other Assistance Text
Please provide detailed information about any other government assistance not listed above. Fill only if 'Any other assistance' is 'Yes'.
Depends on: Any other assistance
Other Names Confirmation
No Checkbox
Check this box if you have never been known by any other name(s). Fill only if 'Are you getting JobSeeker Payment or Youth Allowance (job seeker)?' is 'No'.
Depends on: No
Yes Checkbox
Check this box if you have been known by any other name(s), including those at birth, before marriage, previous married names, Aboriginal/tribal/skin names, aliases, adoptive names, or foster names. Fill only if 'Are you getting JobSeeker Payment or Youth Allowance (job seeker)?' is 'No'.
Depends on: No
Other Name Details Text
Please provide details of any other names you have been known by. This includes names at birth, before marriage, previous married names, aboriginal, tribal or skin names, aliases, adoptive names, or foster names. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Payment Details
Bank Name Text
Please enter the name of the bank, building society, or credit union where the account is held.
Branch Number (BSB) Text
Please provide the Branch number (BSB) for the account.
Max length: 6 characters
Account Number Text
Please enter the account number where you want the payment made.
Account Holder Name Text
Please enter the full name(s) in which the account is held.
Permanent Address
Address Line 1 Text
Please provide the first line of your permanent residential address, including street number and name.
Suburb/Town/City Text
Please provide the suburb, town, or city of your permanent residential address.
Postcode Text
Please provide the postcode of your permanent residential address.
Max length: 4 characters
Postal Address
Address Line 1 Text
Enter the first line of your postal address.
Address Line 2 Text
Enter the second line of your postal address.
Suburb/City/State Text
Enter the suburb, city, or state for your postal address.
Postcode Text
Enter the postcode for your postal address.
Max length: 4 characters
Postgraduate Degree Inquiry
No Checkbox
Check this box if you have not completed an undergraduate or postgraduate degree course.
Yes Checkbox
Check this box if you have completed an undergraduate or postgraduate degree course.
Institution/Campus Name Text
Please provide the name of the institution or campus where the degree course was completed. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Preferred Spoken Language
Preferred Spoken Language Text
Please provide your preferred spoken language. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Preferred Written Language
Preferred Written Language Text
Please provide your preferred written language. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Previous ABSTUDY Payment
No, have not received ABSTUDY Pensioner Education Supplement Checkbox
Check this box if you have not previously received the ABSTUDY Pensioner Education Supplement payment for the course you are currently applying for.
Yes, have received ABSTUDY Pensioner Education Supplement Checkbox
Check this box if you have previously received the ABSTUDY Pensioner Education Supplement payment for the course you are currently applying for.
Previous Benefit Status
No, was not receiving previous benefit Checkbox
Check this box if you were NOT receiving Parenting Payment Single or Disability Support Pension before the grant of your JobSeeker Payment or Youth Allowance.
Yes, was receiving previous benefit Checkbox
Check this box if you WERE receiving Parenting Payment Single or Disability Support Pension before the grant of your JobSeeker Payment or Youth Allowance.
Residential costs payment preference
No Checkbox
Check this box if you do not want your residential costs paid instead of getting the Pensioner Education Supplement while living in a residential college or hostel.
Yes Checkbox
Check this box if you want your residential costs paid instead of getting the Pensioner Education Supplement while living in a residential college or hostel.
Second Completed Course
Second Course Institution Name Text
Provide the name of the institution or campus where the second completed course was undertaken. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Second Course Name Text
Provide the full name of the second completed course. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Second Current Course Study Year
Second Current Course Year Text
Enter the year in which the second current course was or is being studied. Fill only if 'Yes' is 'Yes'.
Max length: 4 characters
Depends on: Yes
Second Current Course Study Stage Text
Enter the stage of study for the second current course (e.g., 1st year, 2nd year). Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Second Current Course Institution Name Text
Enter the full name of the institution where the second current course was or is being studied. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Second Current Course Name Text
Enter the full name of the second current course being studied. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Semester 1 Full-time Checkbox
Check this box if your second current course study year's Semester 1 was full-time. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Semester 1 Part-time Checkbox
Check this box if your second current course study year's Semester 1 was part-time. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Semester 2 Full-time Checkbox
Check this box if your second current course study year's Semester 2 was full-time. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Semester 2 Part-time Checkbox
Check this box if your second current course study year's Semester 2 was part-time. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Second Education Institution/Course
Second Institution Name Text
Provide the name of the second education institution, Australian college, or campus.
Second Student Identification Number Text
Enter your student identification number for the second institution.
Second Course Title Text
Enter the exact title of your second course, for example, 'School Studies' or 'Bachelor of Arts'.
Second Course Code Text
Provide the course code for your second course.
Second Course Year/Stage Text
Specify the year or stage of your second course, for example, 'Year 11' or '1st year, B.Sc.'.
Second Course Study Start Day Text
Enter the day your second course of study will begin.
Max length: 2 characters
Second Course Study Start Month Text
Enter the month your second course of study will begin.
Max length: 2 characters
Second Course Study Start Year Number
Enter the year your second course of study will begin.
Max length: 4 characters
Second Course Study End Day Text
Enter the day your second course of study will end.
Max length: 2 characters
Second Course Study End Month Text
Enter the month your second course of study will end.
Max length: 2 characters
Second Course Study End Year Number
Enter the year your second course of study will end.
Max length: 4 characters
Second Course Official Start Day Text
Enter the day the full period of your second course officially starts.
Max length: 2 characters
Second Course Official Start Month Text
Enter the month the full period of your second course officially starts.
Max length: 2 characters
Second Course Official Start Year Number
Enter the year the full period of your second course officially starts.
Max length: 4 characters
Second Course Official End Day Text
Enter the day the full period of your second course officially ends.
Max length: 2 characters
Second Course Official End Month Text
Enter the month the full period of your second course officially ends.
Max length: 2 characters
Second Course Official End Year Number
Enter the year the full period of your second course officially ends.
Max length: 4 characters
Second Other Course Study Year
Year Number
Please provide the year this other course was undertaken. Fill only if 'Yes' is 'Yes'.
Max length: 4 characters
Depends on: Yes
Year/Stage Text
Please provide the specific year or stage of study for this other course. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Institution Name Text
Please provide the name of the institution where this other course was completed or is being studied. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Course Name Text
Please provide the full name of this other course. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Semester 1 Full-time Checkbox
Check this box if you studied the second other course full-time during Semester 1. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Semester 1 Part-time Checkbox
Check this box if you studied the second other course part-time during Semester 1. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Semester 2 Full-time Checkbox
Check this box if you studied the second other course full-time during Semester 2. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Semester 2 Part-time Checkbox
Check this box if you studied the second other course part-time during Semester 2. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Second Other Name
Second Other Name Text
Please provide the second other name by which you have been known. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Type of Second Other Name Text
Please specify the type of the second other name, such as Aboriginal/Islander name. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Secondary School Student Status
No Checkbox
Check this box if you are not a full-time secondary school student. Fill only if 'Are you studying a Startup Year course?' is 'No'.
Depends on: No
Not sure Checkbox
Check this box if you are unsure whether your course is full-time or part-time. Fill only if 'Are you studying a Startup Year course?' is 'No'.
Depends on: No
Next Question Number Text
Enter the number of the next question to proceed to if you are not a full-time secondary school student. Fill only if 'Are you studying a Startup Year course?' is 'No'.
Depends on: No
Yes Checkbox
Check this box if you are a full-time secondary school student. Fill only if 'Are you studying a Startup Year course?' is 'No'.
Depends on: No
Semester 1 Study Load
75 - 100% Checkbox
Check this box if your Semester 1 full-time study load is between 75% and 100%.
66 - 74% Checkbox
Check this box if your Semester 1 full-time study load is between 66% and 74%.
50 - 65% Checkbox
Check this box if your Semester 1 full-time study load is between 50% and 65%.
25 - 49% Checkbox
Check this box if your Semester 1 full-time study load is between 25% and 49%.
0 - 24% Checkbox
Check this box if your Semester 1 full-time study load is between 0% and 24%.
Not sure Checkbox
Check this box if you are not sure of your Semester 1 full-time study load.
Semester 2 Study Load
75 - 100% Checkbox
Check this box if your full-time study load for Semester 2 is between 75% and 100%.
66 - 74% Checkbox
Check this box if your full-time study load for Semester 2 is between 66% and 74%.
50 - 65% Checkbox
Check this box if your full-time study load for Semester 2 is between 50% and 65%.
25 - 49% Checkbox
Check this box if your full-time study load for Semester 2 is between 25% and 49%.
0 - 24% Checkbox
Check this box if your full-time study load for Semester 2 is between 0% and 24%.
Not sure Checkbox
Check this box if you are not sure of your full-time study load for Semester 2 and will provide a copy of your subjects for assessment.
Semester/Term Address
Semester/Term Address Line 1 Text
Please enter the first line of your semester/term address. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Semester/Term Address Line 2 Text
Please enter the second line of your semester/term address. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Semester/Term Address Line 3 Text
Please enter the third line of your semester/term address. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Semester/Term Suburb/City/State Text
Please enter the suburb, city, and state or territory for your semester/term address. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Semester/Term Postcode Text
Please enter the postcode for your semester/term address. Fill only if 'Yes' is 'Yes'.
Max length: 4 characters
Depends on: Yes
Semester/Term Address Presence Question
No Checkbox
Check this box if you will not have a semester/term address and wish to proceed to the next question.
Yes Checkbox
Check this box if you will have a semester/term address and need to provide the details.
Signature
Your Signature Text
Please provide your signature as required for this declaration. Fill only if 'I have read, understood and agree to the above.' is checked.
Depends on: I have read, understood and agree to the above.
Startup Year Course Status
No Checkbox
Check this box if you are not studying a Startup Year course.
Yes Checkbox
Check this box if you are studying a Startup Year course.
DummyCalcQ27 Text
Study Duration
DummyCalcQ24 Text
More than one year Checkbox
Check this box if your study duration will be longer than one year.
Duration Years Text
Enter the number of full years you will be studying. Fill only if 'More than one year' is 'Yes'.
Max length: 2 characters
Depends on: More than one year
Duration Months Text
Enter the number of additional months you will be studying, if applicable. Fill only if 'More than one year' is 'Yes'.
Max length: 2 characters
Depends on: More than one year
Full school/academic year Checkbox
Check this box if your study duration will be for a full school or academic year.
Study in the following semesters Checkbox
Check this box if your study duration is defined by specific semesters.
Semester 1 Checkbox
Check this box if you will be studying during Semester 1. Fill only if 'Study in the following semesters' is 'Yes'.
Depends on: Study in the following semesters
Semester 2 Checkbox
Check this box if you will be studying during Semester 2. Fill only if 'Study in the following semesters' is 'Yes'.
Depends on: Study in the following semesters
Semester 3 Checkbox
Check this box if you will be studying during Semester 3. Fill only if 'Study in the following semesters' is 'Yes'.
Depends on: Study in the following semesters
Study in the following terms Checkbox
Check this box if your study duration is defined by specific terms.
Term 1 Checkbox
Check this box if you will be studying during Term 1. Fill only if 'Study in the following terms' is 'Yes'.
Depends on: Study in the following terms
Term 2 Checkbox
Check this box if you will be studying during Term 2. Fill only if 'Study in the following terms' is 'Yes'.
Depends on: Study in the following terms
Term 3 Checkbox
Check this box if you will be studying during Term 3. Fill only if 'Study in the following terms' is 'Yes'.
Depends on: Study in the following terms
Term 4 Checkbox
Check this box if you will be studying during Term 4. Fill only if 'Study in the following terms' is 'Yes'.
Depends on: Study in the following terms
Other Checkbox
Check this box if your study duration does not fit the provided options and requires custom date entry.
Study Start Day Text
Enter the day of the month when your study will start. Fill only if 'Other' is 'Yes'.
Max length: 2 characters
Depends on: Other
Study Start Month Text
Enter the month when your study will start. Fill only if 'Other' is 'Yes'.
Max length: 2 characters
Depends on: Other
Study Start Year Text
Enter the year when your study will start. Fill only if 'Other' is 'Yes'.
Max length: 4 characters
Depends on: Other
Study End Day Text
Enter the day of the month when your study will end. Fill only if 'Other' is 'Yes'.
Max length: 2 characters
Depends on: Other
Study End Month Text
Enter the month when your study will end. Fill only if 'Other' is 'Yes'.
Max length: 2 characters
Depends on: Other
Study End Year Text
Enter the year when your study will end. Fill only if 'Other' is 'Yes'.
Max length: 4 characters
Depends on: Other
Study History Requirement
Year of Study to List Text
Please enter the year of study that needs to be listed as part of your past 10 years of study history. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Study Return Question
No Checkbox
Check this box if you are not returning to study after a break of more than one semester.
DummyCalcQ21 Text
Yes Checkbox
Check this box if you are returning to study after a break of more than one semester.
Third Completed Course
Third Institution Name Text
Enter the name of the institution or campus where the third course was completed. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Third Course Name Text
Enter the full name of the third course completed. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Third Current Course Study Year
Study Year Number
Please provide the year in which you undertook this study. Fill only if 'Yes' is 'Yes'.
Max length: 4 characters
Depends on: Yes
Study Stage Text
Please enter the stage or level of study you completed in this year, such as '1st year' or 'Beginner'. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Institution Name Text
Please provide the full name of the educational institution where you undertook this course. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Course Name Text
Please provide the full name of the course you studied. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Semester 1 Full-time Checkbox
Check this box if your study for the third current course in Semester 1 was full-time. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Semester 1 Part-time Checkbox
Check this box if your study for the third current course in Semester 1 was part-time. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Semester 2 Full-time Checkbox
Check this box if your study for the third current course in Semester 2 was full-time. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Semester 2 Part-time Checkbox
Check this box if your study for the third current course in Semester 2 was part-time. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Third Other Course Study Year
Study Year Text
Enter the year in which this course of study took place. Fill only if 'Yes' is 'Yes'.
Max length: 4 characters
Depends on: Yes
Study Stage Text
Enter the stage or year level of this course of study. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Institution Name Text
Enter the full name of the institution where this course of study was undertaken. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Course Name Text
Enter the full name of the course of study. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Semester 1 Full-time Checkbox
Check this box if the third other course listed was studied full-time during Semester 1. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Semester 1 Part-time Checkbox
Check this box if the third other course listed was studied part-time during Semester 1. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Semester 2 Full-time Checkbox
Check this box if the third other course listed was studied full-time during Semester 2. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Semester 2 Part-time Checkbox
Check this box if the third other course listed was studied part-time during Semester 2. Fill only if 'Yes' is 'Yes'.
Depends on: Yes
Your Name
Title1_Mr CheckBox
Title1_Mrs CheckBox
Title1_Miss CheckBox
Title1_Ms CheckBox
Title1_Mx CheckBox
Other Title Text
Please specify your preferred title if it is not Mr, Mrs, Miss, Ms, or Mx. Fill only if 'Are you getting JobSeeker Payment or Youth Allowance (job seeker)?' is 'No'.
Depends on: No
Family Name Text
Please enter your family name or surname. Fill only if 'Are you getting JobSeeker Payment or Youth Allowance (job seeker)?' is 'No'.
Depends on: No
First Given Name Text
Please enter your first given name. Fill only if 'Are you getting JobSeeker Payment or Youth Allowance (job seeker)?' is 'No'.
Depends on: No
Second Given Name Text
Please enter your second given name, if applicable. Fill only if 'Are you getting JobSeeker Payment or Youth Allowance (job seeker)?' is 'No'.
Depends on: No