| Occupation as written | Teacher of Music |
| Standardised occupation | PP13: Public services and Professionals - Education |
| Application received | 4 Sep 1911 |
| Application status | Approved |
| Official | JAM |
| Date of approval or denial | 5 Sep 1911 |
| If rejected, why? | |
| Birthplace as written | Carlton, Victoria, Australia |
| Modern country | Australia |
| Age on application | 43 |
| Age on arrival in Australia | None |
| Port of Departure | None |
| Port of Arrival | None |
| Date of arrival | None |
| Name of ship | None |
| Address in Australia | 3 Grove Rd., Hawthorn |
| Address State | Victoria |
| Time at address | 23 years |
| Previous address 1 | Carlton |
| Address State | Victoria |
| Time at address | 21 years |
| Married | Yes | |
| Children | Yes | 4: 3 girls and 1 boy, with her and husband |
| Name of reference | James Houston |
| Occupation of reference | State School Teacher (Victoria) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |