Private and Confidential
All questions must be answered.
Please fill in a separate form for you and your spouse if he/ she may be considered as the Principal Applicant.
Your Personal Details: (as it appears on your passport)
Applicant Name
First name *
:
Middle Name
:
Last Name *
:
Present Address *
:
Permanent Address
:
Telephone #: Residence *
:
Office
:
Mobile *
:
Fax
:
E-mail *
:
Date of Birth *
:
Gender
:
Male
Female
Marital Status*
:
Married
Unmarried
Present Citizenship *
:
Country of Residence
:
Occupation with current designation
:
Spouse Details:
Name
:
Date of Birth
:
Country of Birth
:
Country of Citizenship
:
Occupation with current designation
:
Do you have any children
:
Yes
No
Children’s Details:
Name
Gender
Age
Educational Background
(Starting with S.S.C standard onwards)
Month & Year
of Passing
Name of the Institution
( School/ College/ University)
No. of years
completed
Name of the Certificate/Diploma/Degree Received
Certificate/Diploma/ Degree
Full Time/ Part Time/ Correspondence
Spouse’s Educational Background:
(Starting with S.S.C standard onwards)
Month & Year
of Passing
Name of the Institution
( School/ College/ University)
No. of years
completed
Name of the Certificate/Diploma/Degree Received
Certificate/Diploma/ Degree
Full Time/ Part Time/ Correspondence
Trade / Technical / Vocational School / Apprenticeship
Month & Year
of Passing
Name of the Institution
( School/ College/ University)
No. of years
completed
Name of the Certificate/Diploma/Degree Received
Certificate/Diploma/ Degree
Full Time/ Part Time/ Correspondence
Detailed Work Experience (Since your 18th birthday) Please provide your resume in detail with job responsibilities separately
Full Time Positions, starting with Current Job
From
To
Name of The Employer
Position
Month
Year
Month
Year
Arranged Employment :
Do you have an offer of employment from a New Zealand Company, if so provide details.
Relatives :
Do you or your spouse have any relatives who live in New Zealand with
Permanent Residency status? (YES / NO)
:
Relationship (brother/sister/parents)
:
Address
:
Telephone
:
Will your relative undertake to provide you with accommodation / financial guarantee for your stay in
New Zealand after your arrival?
:
Language Ability:
English
Speak
Read
Write
Have you completed the all your studies in English Medium?
Yes
No
Have you done an IELTS testing? If yes, please mention scores
Bands
Speaking
Reading
Writing
Listening
Score
The test was in
General
or
Academic level
Have you or any of your immediate family ever been: (Yes /No)
Convinced or charged with a crime?
Yes
No
Applied for Immigrant/ Visitor’s Visa?
Yes
No
Refused Immigrant/ Visitor’s Visa?
Yes
No
Refused admission or ordered to leave a country or any other country?
Yes
No
Suffered from or treated for any physical or mental disability
Yes
No
Or have any health problem?
Yes
No
If the answer to any of the above Questions is “Yes”, please explain
Any other information not otherwise requested which may be relevant
DECLARATION: I declare that the above information I have given in this Application Form is truthful, complete and that I am responsible for any errors, commissions and false information submitted here above.
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