What is your full name?
2. What is your citizenship?
3. What is your sex?
4 (a) What is your date of birth?
4 (b) Are you currently married?
Yes
No
If "yes", please state your spouse's full name:
4 (c) What is your spouse's citizenship
4 (d) Have you or your current spouse ever been previously married?
You:
Yes
No
Your spouse:
Yes
No
5. Do you or your spouse have any relatives currently living in New Zealand with permanent residence or citizenship?
Yes
No
If "yes" how long have they had permanent residence in NZ?
And what is your relationship to them (eg. niece, father...)
6. Please indicate below your own English speaking ability. If you are married and have children, please provide the same information for your spouse and any of your children who are older that 16 but less that 20 years old and who you wish to include in your residence application.
Please tick relevant entry below
7 (a).
If you have children who would be included in your residency application please list their full names and their dates of birth:
7 (b). Please state whether any of the children you have listed in question 7 (a) were from a previous marriage which you or your spouse entered into.
Yes
No
If "Yes", please state the names of these children.
Please state whether you / your spouse now have full custody (ie: pursuant to a Court Order) of the child(ren) listed in 7(b).
Yes
No
If "yes" please state whether the child(ren)'s other natural parent would consent to the child(ren) being permanently removed (if immigrating with you) from their home country:
Yes
No
7 (c). If you and / or your spouse and / or any of your children who are 17 or older and will be included in your application have spent a total of more than 12 months physically present in any country (other than your home country) within the past 10 years please set out the name of the individual(s) and the country or countries in which the time has been spent. (Example : seven years ago your wife studied in France for 7 months and three years ago she returned to France to study for six more months: she has been therefore "physically present" in France within the past 10 years for a total of more than 12 months).
7 (d).
Do you, your spouse or any of your children who would be included in the application have any existing health problems which would require medical treatment in New Zealand? (This could include diabetes, heart problems, tuberculosis, obesity, high blood pressure, etc - but is not limited to those problems only). If so, please detail them below:
7 (e).
Have you, your spouse, or any child of yours 17 years or older who would be included in your application, ever been convicted of any offence against the law in any country? If so, please detail below:
8. Did you graduate from High School?
Yes
No
9 (a). If you have any post high school education, please provide full details of the following:
a) Full name of college or university or polytechnic from which degree was obtained:
b) Field of study in which degree obtained:
c) Name of Diploma or certificate which you obtained (ie: Bachelors Degree, Licence, etc):
d) The length of time normally required to obtain that type of diploma, certificate or degree; if you received a "grade" when you obtained the degree (ie: "good" or "first class" etc) please also state what the grade was:
e) The month and year in which you obtained the degree, certificate or diploma:
f) If you obtained any post-graduate degrees please set out the names of those degrees, the fields of study in which they were obtained, the name of the institution from which they were obtained, the grade you received (if applicable) and the month and year in which you obtained each post-graduate degree:
9 (b). If your spouse has any post high school education, please provide full details of the following:
a) Full name of college or university or polytechnic from which degree was obtained:
b) Field of study in which degree obtained:
c) Name of Diploma or certificate which you obtained (ie: Bachelors Degree, Licence, etc):
d) The length of time normally required to obtain that type of diploma, certificate or degree; if you received a "grade" when you obtained the degree (ie: "good" or "first class" etc) please also state what the grade was:
e) The month and year in which you obtained the degree, certificate or diploma:
f) If you obtained any post-graduate degrees please set out the names of those degrees, the fields of study in which they were obtained, the name of the institution from which they were obtained, the grade you received (if applicable) and the month and year in which you obtained each post-graduate degree:
10. If you do not have an academic qualification, have you completed training or obtained a qualification in a trade or vocation? (example: carpentry, plumbing, etc):
Yes
No
If "yes", state your trade / vocation field:
How long did it take to qualify?
Name of qualification and institute it was gained from:
Did you have to serve an apprenticeship to obtain the qualifiction?
Yes
No
Date you obtained your trade / vocation qualification:
11(a).
Please show below, your complete employment history. (Please be sure to state the day, month and year that you began and finished working for each employer, if at all possible). Work experience gained both before and after obtaining a qualification may count for immigration points, if the work experience is relevant to your qualification, (eg: applicant started as an accounts clerk, worked up to manager of accounts department and achieved an accounting qualification along the way).
11 (b). If the work experience outlined above is in an area slightly different to that of your qualification, please state how it is relevant to that qualification (ie:if / how that qualification was a significant factor in being able to secure or advance in the position).
12. Do you have a job offer in New Zealand?
Yes
No
If "yes", please state the position offered:
Name of employer:
13. Do you have work experience in New Zealand?
Yes
No
If "yes", please state the position held:
Duration of the position:
14. Please state whether you (or you and your spouse jointly) own assets (ie: cash, house, car, stocks, etc) with a total value of more than NZD$100,000 or more than NZD$200,000. Under the General Skills Category an applicant is automatically given 1 point if he or she can prove her or she has assets worth more than NZD$100,000 and 2 points for assets worth more than NZD$200,000. (Please note that you would need to liquidate assets and transfer the funds to New Zealand if your application is approved).
Assets valuing over NZD$100,000
Assets valuing over NZD$200,000
NB: Questions 15-19 (inclusive) need only be answered by Applicants under the Business Investor Category.
15.
What is the MAXIMUM amount of money, expressed in New Zealand dollars, which you would be able and prepared to invest in New Zealand as part of your residency application? (Business Investor Category applicants only).
NZD$1,000,000
NZD$1,500,000
NZD$2,000,000
NZD$2,500,000
NZD$3,000,000
NZD$3,500,000
NZD$4,000,000
NZD$4,500,000
NZD$5,000,000
NZD$5,500,000
NZD$6,000,000
16. Please state whether you own you own business.
Yes
No
If so, how long you have owned your own business
17. If you are prepared to invest more than NZD$100,000 in New Zealand, can you prove that the amount of money which you would be investing in New Zealand has been accumulated from your own efforts as a direct result of your business experience (ie: that you have saved the money form your own businesses' profits or the money has been accumulated as returns on investments of funds as a direct result of your business experience. (This question only needs to be answered if you could invest NZD$100,000 or more in New Zealand).
Yes
No
18. Please state whether you have at least 2 years experience in conducting your own business or as senior management of a lawful business enterprise.
19. Do you have business experience in New Zealand? (Business experience is defined as owning a business in New Zealand or senior management experience in a business in New Zealand).
Yes
No
If "yes", is that experience for one full year or two or more full years?
Yes
No
20. Please set out below your full postal address, telephone number, e-mail address (if any) and, a "safe" facsimile number which we can use to communicate with you about immigration matters:
Postal Address:
Telephone Number:
Facsimile Number:
Email Address:
21. NB: If you are married and your spouse has educational qualifications and work experience similar to yours you should also send to us one of these questionnaires separately completed for your spouse, as your spouse may be able to score more points than you and therefore be a better principal applicant .
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