Visa Assessment Form

Kindly complete this form as fully as possible to give as clear a picture of your current circumstances as possible. Please ensure that you attach your CV[s]  as this help in the preparation of your report.

Alternativly, download and print out the PDF and return via fax (+64 6 769 5005) or mail to BritsNZ Ltd, PO Box 5107, Westown, New Plymouth, Taranaki.

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Principal Applicant Name*

Date of Birth*

NationalitySelect OneAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBarbadosBangladeshBelarusBelgiumBelizeBeninBermudaBhutanBotswanaBoliviaBosnia and HerzegovinaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo, Democratic RepublicCook IslandsCosta RicaIvoire (Ivory Coast)Croatia (Hrvatska)CubaCyprusCzech RepublicDenmarkDjibouti--Add Me - module:FormBuilder string:DM --Dominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrance, MetropolitanGuernseyFrench PolynesiaFrench Southern TerritoriesF.Y.R.O.M. (Macedonia)GabonGambiaGeorgiaGermanyGhanaGibraltarGreat Britain (UK)GreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelIsle of ManItalyJerseyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea (North)Korea (South)KuwaitKyrgyzstanLaosLatviaLebanonLiechtensteinLiberiaLibyaLesothoLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMonacoMoldovaMoroccoMongoliaMontserratMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNeutral ZoneNew CaledoniaNew Zealand (Aotearoa)NicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaS. Georgia and S. Sandwich Isls.Saint Kitts and NevisSaint LuciaSaint Vincent & the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSeychellesSierra LeoneSingaporeSloveniaSlovak RepublicSolomon IslandsSomaliaSouth AfricaSpainSri LankaSt. HelenaSt. Pierre and Miquelon SudanSurinameSvalbard & Jan Mayen IslandsSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUS Minor Outlying IslandsUruguayUzbekistanVanuatuVatican City State (Holy See)VenezuelaViet NamVirgin Islands (British)Virgin Islands (U.S.)Wallis and Futuna IslandsWestern SaharaYemenYugoslaviaZambiaZimbabwe

Mobile No

Home Ph

Email Address

Current Profession

Address

Dependent children (please include names and DOB)

Partners Name

Partners Date of Birth

Partners NationalitySelect OneAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBarbadosBangladeshBelarusBelgiumBelizeBeninBermudaBhutanBotswanaBoliviaBosnia and HerzegovinaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo, Democratic RepublicCook IslandsCosta RicaIvoire (Ivory Coast)Croatia (Hrvatska)CubaCyprusCzech RepublicDenmarkDjibouti--Add Me - module:FormBuilder string:DM --Dominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrance, MetropolitanGuernseyFrench PolynesiaFrench Southern TerritoriesF.Y.R.O.M. (Macedonia)GabonGambiaGeorgiaGermanyGhanaGibraltarGreat Britain (UK)GreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelIsle of ManItalyJerseyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea (North)Korea (South)KuwaitKyrgyzstanLaosLatviaLebanonLiechtensteinLiberiaLibyaLesothoLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMonacoMoldovaMoroccoMongoliaMontserratMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNeutral ZoneNew CaledoniaNew Zealand (Aotearoa)NicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaS. Georgia and S. Sandwich Isls.Saint Kitts and NevisSaint LuciaSaint Vincent & the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSeychellesSierra LeoneSingaporeSloveniaSlovak RepublicSolomon IslandsSomaliaSouth AfricaSpainSri LankaSt. HelenaSt. Pierre and Miquelon SudanSurinameSvalbard & Jan Mayen IslandsSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUS Minor Outlying IslandsUruguayUzbekistanVanuatuVatican City State (Holy See)VenezuelaViet NamVirgin Islands (British)Virgin Islands (U.S.)Wallis and Futuna IslandsWestern SaharaYemenYugoslaviaZambiaZimbabwe

Partners Mobile No

Partners Home Ph

Partners Current Profession

Which Visa are you looking to apply for?*

 Skilled

 Business

 Family

 Work

 Investor

 Retirement

Do you or your partner speak ENGLISH fluently?*

 Yes

 No

Have you previously applied for a VISA*

 Yes

 No

If "yes" please give details and any INZ reference numbers

What is your highest attained educational qualification*

 Degree

 Diploma

 Trade

 Other

Name, educational institution and date of qualification (if applicable)

What is your partners highest attained educational qualification

 Degree

 Diploma

 Trade

 Other

Name, educational institution and date of partners qualification (if applicable)

Relevant Work Experience

 2 years

 4 years

 6 years

 8 years

 10+ years

Do you or your partner have a job offer in New Zealand?

 Yes

 No

Do you have a partner of more than 12 months who is a NZ citizen or permanent resident?

 Yes

 No

Do you have any family living in NZ?

 Yes

 No

How long have they been in NZ? Do they have Residency?

Do you or your partner own and operate your own business?

 Yes

 No

Annual Turnover?

Do you or your partner possess assets & saving of about £1.5M?

 Yes

 No

Have you or any of those accompanying you had any serious medical conditions?

 Yes

 No

If "yes" please give brief medical details

Have you or any of those accompanying you ever been charged or convicted of a criminal offence, been deported from a country, or refused a Visa?

 Yes

 No

If "yes" please give brief Details

I hereby state that this information is, to the best of my knowledge, an accurate and truthful statement of my situation.

Upload CV  Extensions: pdf,doc,docx

Partner CV  Extensions: pdf,doc,docx

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