Contact Details
First Name: Last Name: Email: Postal Address: Phone Number: Personal Information Gender: Date of Birth:
Country of Birth: Citizenship(s) held: Partnership Status: Please select Never Married Married Partner Engaged Separated Widowed Divorced Spouse/Partner Details First Name: Last Name: Gender: Date of Birth:
Citizenship(s) held: How long have you been living together? Children Do you or your spouse have any children? Please Select Yes No If yes, please list the names of all your children and your partner's children including those who are not living with you: Name: Date of birth:
Country of Residence: Country of Citizenship: Name: Date of Birth:
Country of Residence: Country of Citizenship : Name: Date of Birth :
Country of Residence: Country of Citizenship : Name: Date of Birth :
Country of Residence: Country of Citizenship: Do you or your spouse/partner have any brothers/sisters or parents permanently living in New Zealand? Please select Yes No Please indicate your English language ability: Please select Fluent Competent Limited Please indicate your spouse's English language ability: Please Select Fluent Competent Limited Have you sat the IELTS test within the last two years? Please select Yes No If yes, what date and what was your overall band score: Date: Overall band score: Character Have you or your spouse, or any chlid of yours 17 years or older who would be included in your application have any criminal convictions? Please select Yes No If yes, please provide details: Health Have you or your spouse, or any dependant who will be included in your application have any existing health problems? Please select Yes No If yes, please provide details: Educational Qualifications Do you have any tertiary educational qualifications? Please Select Yes No Please enter the details of all the qualifications you have obtained: Qualification Type: Major: Name of Institution: Start date: Finish date: Qualification Type: Major: Name of Institution: Start date: Finish date: Qualification Type: Major: Name of Institution: Start date: Finish date: Qualification Type: Major: Name of Institution: Start date: Finish date: Spousal Educational Qualifications Does your spouse have any tertiary educational qualifications? Please Select Yes No Qualification Type: Major: Name of Institution: Start date: Finish date: Qualification Type: Major: Name of Institution: Start date: Finish date: Work Experience Please complete below your complete employment history: Job Title: Full Time: Part Time: Company Name: Start date: Finish date: Brief description of the type of work that you do or did? Job Title: Full Time: Part Time: Company Name: Start date: Finish date: Brief description of the type of work that you do or did? Job Title: Full Time: Part Time: Company Name: Start date: Finish date: Brief description of the type of work that you do or did? Job Title: Full Time: Part Time: Company Name: Start date: Finish date: Brief description of the type of work that you do or did? Job Title: Full Time: Part Time: Company Name: Start date: Finish date: Brief description of the type of work that you do or did? Job Title: Full Time: Part Time: Company Name: Start date: Finish date: Brief description of the type of work that you do or did? Employment in New Zealand Do you have a full time offer of employment in New Zealand? Please Select Yes No If yes, please provide details of employer and position: Business or Management Experience Have you or your spouse/partner ever owned your own business? Please Select Yes No If yes, please provide brief details: Funds What is the maximum amount of money in New Zealand Dollars, which you or your spouse/partner would be able to liquidate and transfer to New Zealand (for a possible application under a business category)? Please Select $100,000.00 to $150,000.00 $150,000.00 to $200,000.00 $200,000.00 to $250,000.00 More than $250,000.00