Contact
Info
Valid e-mail address:
Note: If this field is left blank or is
incorrect, we will be unable to return your assessment result to
you.
Personal Info
Your Nationality:
Last/Family Name:
First Name(s):
Date of Birth:
- 01
02 03 04
05 06 07
08 09 10
11 12 13
14 15 16
17 18 19
20 21 22
23 24 25
26 27 28
29 30 31
-
January February March
April May
June July
August September October
November December
day
month year
Sex:
Male
Female
Marital Status:
Single
Married or DeFacto/Common Law Separated
Divorced Widowed
Spouse/Partner's first and last Name:
(if applicable)
Spouse/Partner's Nationality:
Spouse/Partner's Date of Birth:
- 01
02 03 04
05 06 07
08 09 10
11 12 13
14 15 16
17 18 19
20 21 22
23 24 25
26 27 28
29 30 31
-
January February March
April May
June July
August September October
November December
day
month year
Spouse/Partner's highest Education:
Please Select
Primary (Elementary)
Secondary (High School)
Vocational/Tertiary Diploma - 1 Year
Vocational/Tertiary Diploma- 2 Years
Vocational/Tertiary Diploma - 3 Years
University/Bachelors - 2 Years
University/Bachelors - 3 Years
University/Bachelors - 4 Years
University/Masters
University/Doctorate or Ph. D.
Not Completed
Please indicate the number of dependent children that you
have:
12 years and under:
(0-12 years)
age 13 years and older:
(13 years and older)
Relative
Residing Within New Zealand
Do you (or your accompanying
spouse) have a close relative residing in New Zealand, who is a citizen or
holds permanent resident status in New Zealand? If so, please
provide us with the relationship of the closest relative and the
location in which your relative resides.
Relationship:
No Relative in New Zealand
Mother or Father Grandmother or
Grandfather Brother or Sister
Lawful Guardian
Spouse or Fiancé(e) Daughter or
Son
(Visa) status:
No status Permanent resident -3 years
Permanent Resident +3 years NZ Citizen
Location:
No
Relative in New Zealand Northland
Auckland Taranaki
Wellington Hawkes Bay
Nelson Marlborough
Canterbury Westland
Otago Southland
Other
Relatives
residing in your country of origine/country where you reside legally
Do you, as a main applicant,
have close family members staying in the same country where you reside legally and who DO NOT accompany you to NZ? If so, please
state their relationship to you: parent(s), brother(s), sister(s) or child(ren)
Details:
Please
provide full details.
Funds available for transfer to New Zealand upon entering the country as a permanent resident/investor
Amount:
NZ$100.000+
NZ$200.000+
less than NZ$100.000
more than NZ$2million
Details:
If amount over NZ$2million, please state the amount.
Language
Abilities
Please indicate your
proficiency in the English language, as
follows: High: Very good command of the language
in a range of social and work situations and no difficulty
communicating in a professional capacity.Moderate:
Can communicate reasonably well about personal and familiar
things.Basic: Command of just a few basic
words.
Proficiency:
Speak
Read
Write
Listen
English:
High Moderate
Basic Not at All
High Moderate
Basic Not at All
High Moderate
Basic Not at All
High Moderate
Basic Not at
All
Employment & Education
Information
We require
detailed information about your education and recent
employment history to complete the assessment. The information must
contain start and end dates, name and place of studies/employment,
specialized field of study in the case of education, and detailed
description of duties in the case of employment.
Education
Total years of education:
Please provide us with complete
details of your most recent education first.
Educational
Degree/Diploma No. 1
Started In:
- January February
March April
May June
July August
September October November
December
Ended In:
- January February
March April
May June
July August
September October November
December
month year
Institution:
City, Country:
Field of Study:
Certificate:
Please Select
Diploma - 1 Year Diploma - 2
Years Diploma - 3 Years
Bachelors - 2 Years Bachelors - 3
Years Bachelors - 4 Years
Masters or Post-Graduate Diploma
Doctorate or Ph. D. Other
Not Completed
Educational
Degree/Diploma No. 2 (if applicable)
Started In:
- January February
March April
May June
July August
September October November
December
Ended In:
- January February
March April
May June
July August
September October November
December
month year
Institution:
City, Country:
Field of Study:
Certificate:
Please Select
Diploma - 1 Year Diploma - 2
Years Diploma - 3 Years
Bachelors - 2 Years Bachelors - 3
Years Bachelors - 4 Years
Masters or Post-Graduate Diploma
Doctorate or Ph. D. Other
Not Completed
Educational
Degree/Diploma No. 3 (if applicable)
Started In:
- January February
March April
May June
July August
September October November
December
Ended In:
- January February
March April
May June
July August
September October November
December
month
year
Institution:
City, Country:
Field of Study:
Certificate:
Please select
Diploma - 1 Year Diploma - 2
Years Diploma - 3 Years
Bachelors - 2 Years Bachelors - 3
Years Bachelors - 4 Years
Masters or Post-Graduate Diploma
Doctorate or Ph. D. Other
Not Completed
Remarks:
Describe
any additional diplomas, certificates or training that you have
received here.
Employment
History
Please provide us with complete
details of your most recent Employment History.
Your Profession: example: Carpenter, Lawyer, Midwife - not : Manager, Assistant, Director
Present
Employment
Joined In:
- January February
March April
May June
July August
September October November
December
month year
Employer:
City, Country:
Title:
Duties:
IMPORTANT:
Please provide a detailed description of your duties.
Previous Employment No. 1
(if applicable)
Joined In:
- January February
March April
May June
July August
September October November
December
Left In:
- January February
March April
May June
July August
September October November
December
month year
Employer:
City, Country:
Title:
Duties:
IMPORTANT:
Please provide a detailed description of your duties.
Previous Employment No. 2
(if applicable)
Joined In:
- January February
March April
May June
July August
September October November
December
Left In:
- January February
March April
May June
July August
September October November
December
month year
Employer:
City, Country:
Title:
Duties:
IMPORTANT:
Please provide a detailed description of your duties.
Remarks:
Describe
any additional work/business or employment experience here and please statethe total number of years of ongoing work experience that is
relevant to your qualifications/diplomas!
Curriculum
Vitae & Comments
CV Paste Area:
You may
"cut and paste" a detailed curriculum vitae in this area.
Remarks:
Please
mention any prior applications for permanent residence, any known
medical issues, criminal issues/convictions, etc.
Optional but appreciated:
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did you hear about NewZealand-InfoCenter.com? Make a
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Form
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assessment result will be sent to you by email within 2 NZ working days but please allow for some delay possible due to time zone difference. An automated
response webpage acknowledging receipt of your form will appear
immediately upon submission. This page contains a shopping cart for the required payment of US$60 towards processing of your assessment.
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assessment request. By submitting this form you declare to agree with the conditions for the use of this form.