Work Visa

Application Form.

Personal details

Family/last name as shown in your passport

Given/first name as shown in your passport

Prefererred title

Other names your are known by or have ever been nown by

Gender

Date of birth

Town city of birth

Country of birth

Passport number

Passport Country

Passport date of expiry

Passport issue date

Other citizenships you hold

Parnership status

Contact details

Your current residential address:

Address

Telephone (landline)

Telephone (mobile)

If you are currently in New Zealand, your most recent overseas address.

Address

Do you authorise the person stated above to act on your behalf?

Yes/No

Yes No

Do you authorise all other licensed immigration advisers or persons exempt from licensing who work for the organisation named above to act on your behalf (if applicable)?

Yes/No

Yes - Note: the person identifed above will receive all communication from Immigration New Zealand. No - Only the person indicated above may act on my behalf.

Have you received immigration advice on this application?

Yes/No

Yes - Make sure that your immigration adviser completes the section on Immigration adviser’s details’. No

Names and addresses of any friends, relatives, or contacts you have in New Zealand (if applicable).

Name

Address

Relationship

Date of Birth (if known)

Name

Address

Relationship

Date of Birth (if known)

Your Health

Do you have tuberculosis (TB)?

Yes/No

Yes No

Do you have any medical condition that requires, or may require, one of the following during your stay in New Zealand?

Renal dialysis

Yes/No

Yes No

Hospital care

Yes/No

Yes No

Residential care

Yes/No

Yes No

Residential care is defned as in-patient care for people with psychiatric, sensory or intellectual disabilities or live-in facilities for the aged.

If you have answered Yes to any of the questions above, provide details

Are you pregnant?

Yes/No

Yes No

Date you are due to give birth

If you intend to give birth in New Zealand, please indicate how the cost of maternity health services will be paid for and provide the relevant evidence.

Yes/No

Not applicable as I do not intend to give birth in New Zealand. I am, or will be eligible for publicly-funded maternity health services and have provided evidence of my eligibility. I will cover the cost myself and have attached copies (not originals) that I have at least NZ$9000 of funds available. My sponsor has guaranteed to cover the cost and I have attached a completed Sponsorship Form for Temporary Entry (INZ 1025).

Upload Sponsorship Form for Temporary Entry (INZ 1025) (if applicable)

Sponsorship Form for Temporary Entry (INZ 1025

Your character

All applicants must complete this section. If your application is declined for character reasons, Immigration New Zealand may place a notation in your passport indicating that you applied for a visa for New Zealand.

Have you been convicted at any time of any offence, including any driving offence? Please note that this includes any conviction(s) outside of New Zealand subsequently cleared or wiped by ‘clean slate’ legislation

Yes/No

Yes No

Are you currently under investigation for any offence in any country?

Yes/No

Yes No

Are you currently wanted for questioning for any offence in any country?

Yes/No

Yes No

Are you currently facing charges for any offence in any country?

Yes/No

Yes No

Have you ever been excluded from any country, excluding New Zealand?

Yes/No

Yes No

Have you ever been refused entry from any country, excluding New Zealand?

Yes/No

Yes No

Have you ever been removed or deported from any country, excluding New Zealand?

Yes/No

Yes No

Have you ever been refused a visa/permit to visit, work, study or reside in any country?

Yes/No

Yes No

Have you ever been a member of, or adhered to, any terrorist organisation?

Yes/No

Yes No

Have you had (or currently have) an association with, membership of, or involvement with, any government, regime, group or agency that has advocated or committed war crimes, crimes against humanity and/or other gross human rights abuses?

Yes/No

Yes No

If you have answered yes to any of the questions above give full details. This includes full details of any charges, convictions and the sentence or penalty imposed.

More Information

File Upload

Employment and Qualification

List all periods of previous employment, including self-employment and employment outside New Zealand.

Date from

Date to

Name of employer

Location

Occupation/Job title

Date from

Date to

Name of employer

Location

Occupation/Job title

Date from

Date to

Name of employer

Location

Occupation/Job title

Give details of all qualifcations you hold. If you have no qualifcations, write ‘No qualifcations’.

Name of qualification

Date obtained

Institution where gained

Name of qualification

Date obtained

Institution where gained

Name of qualification

Date obtained

Institution where gained

Declaration by applicant

I have provided true and correct answers to the questions in this form.

I understand that if false or misleading information is submitted, my application may be declined without further warning.

I agree to tell Immigration New Zealand about any changes to my circumstances (including a change in my employment or partnership status) that occur after making this application.

I agree to leave New Zealand before my visa expires. If I remain in New Zealand after my visa has expired, I may be deported by Immigration New Zealand.

I agree that if I am not entitled to free health care in New Zealand, I will pay for any health care or medical assistance I may require in New Zealand.

I understand that if I have received immigration advice from an immigration adviser and if that immigration adviser is not licensed under the Immigration Advisers Licensing Act 2007 when they should be, Immigration New Zealand will return my application.

I understand that Immigration New Zealand may provide information about my entitlement to work to potential employers including via the online VisaView system. If I undertake a course of study while in New Zealand, I authorise Immigration New Zealand to provide information about my immigration status to my education provider, including via VisaView.

I authorise Immigration New Zealand to provide Information about my health and my immigration status to any health service agency. I authorise any health service agency to provide information about my health to Immigration New Zealand.

I authorise Immigration New Zealand to make any necessary enquiries about information on this form and/or accompanying documentation. I authorise any agency whether in New Zealand or overseas, including but not limited to border or immigration agencies, education providers, fnancial institutions, foreign embassies, government authorities, healthcare providers, police or other law enforcement agencies, that holds information (including personal information) related to information on this application form and/or accompanying documentation to disclose that information to Immigration New Zealand so that they can:
• make a decision on this application
• answer enquiries about my immigration status once my application has been decided.

By selecting yes to this declaration you agree to the above items contained within this form.

By selecting yes and clicking Send you agree that this constituents a digital signature

Yes/No

Yes No

Today's date

Work Visa

Application Form

Personal details

Family/last name as shown in your passport

Given/first name as shown in your passport

Prefererred title

Other names your are known by or have ever been nown by

Gender

Date of birth

Town city of birth

Country of birth

Passport number

Passport Country

Passport date of expiry

Passport issue date

Other citizenships you hold

Parnership status

Contact details

Your current residential address:

Address

Telephone (landline)

Telephone (mobile)

If you are currently in New Zealand, your most recent overseas address.

Address

Do you authorise the person stated above to act on your behalf?

Yes/No

Yes No

Do you authorise all other licensed immigration advisers or persons exempt from licensing who work for the organisation named above to act on your behalf (if applicable)?

Yes/No

Yes - Note: the person identifed above will receive all communication from Immigration New Zealand. No - Only the person indicated above may act on my behalf.

Have you received immigration advice on this application?

Yes/No

Yes - Make sure that your immigration adviser completes the section on Immigration adviser’s details’. No

Names and addresses of any friends, relatives, or contacts you have in New Zealand (if applicable).

Name

Address

Relationship

Date of Birth (if known)

Name

Address

Relationship

Date of Birth (if known)

Your Health

Do you have tuberculosis (TB)?

Yes/No

Yes No

Do you have any medical condition that requires, or may require, one of the following during your stay in New Zealand?

Renal dialysis

Yes/No

Yes No

Hospital care

Yes/No

Yes No

Residential care

Yes/No

Yes No

Residential care is defned as in-patient care for people with psychiatric, sensory or intellectual disabilities or live-in facilities for the aged.

If you have answered Yes to any of the questions above, provide details

Are you pregnant?

Yes/No

Yes No

Date you are due to give birth

If you intend to give birth in New Zealand, please indicate how the cost of maternity health services will be paid for and provide the relevant evidence.

Yes/No

Upload Sponsorship Form for Temporary Entry (INZ 1025) (if applicable)

Sponsorship Form for Temporary Entry (INZ 1025

Your character

Yes/No

Yes No

Are you currently under investigation for any offence in any country?

Yes/No

Yes No

Are you currently wanted for questioning for any offence in any country?

Yes/No

Yes No

Are you currently facing charges for any offence in any country?

Yes/No

Yes No

Have you ever been excluded from any country, excluding New Zealand?

Yes/No

Yes No

Have you ever been refused entry from any country, excluding New Zealand?

Yes/No

Yes No

Have you ever been removed or deported from any country, excluding New Zealand?

Yes/No

Yes No

Have you ever been refused a visa/permit to visit, work, study or reside in any country?

Yes/No

Yes No

Have you ever been a member of, or adhered to, any terrorist organisation?

Yes/No

Yes No

Yes/No

Yes No

If you have answered yes to any of the questions above give full details. This includes full details of any charges, convictions and the sentence or penalty imposed.

More Information

File Upload

Employment and Qualification

List all periods of previous employment, including self-employment and employment outside New Zealand.

Date from

Date to

Name of employer

Location

Occupation/Job title

Date from

Date to

Name of employer

Location

Occupation/Job title

Date from

Date to

Name of employer

Location

Occupation/Job title

Give details of all qualifcations you hold. If you have no qualifcations, write ‘No qualifcations’.

Name of qualification

Date obtained

Institution where gained

Name of qualification

Date obtained

Institution where gained

Name of qualification

Date obtained

Institution where gained

Declaration by applicant

I have provided true and correct answers to the questions in this form.

I understand that if false or misleading information is submitted, my application may be declined without further warning.

I agree to tell Immigration New Zealand about any changes to my circumstances (including a change in my employment or partnership status) that occur after making this application.

I agree to leave New Zealand before my visa expires. If I remain in New Zealand after my visa has expired, I may be deported by Immigration New Zealand.

I agree that if I am not entitled to free health care in New Zealand, I will pay for any health care or medical assistance I may require in New Zealand.

I authorise Immigration New Zealand to make any necessary enquiries about information on this form and/or accompanying documentation. I authorise any agency whether in New Zealand or overseas, including but not limited to border or immigration agencies, education providers, fnancial institutions, foreign embassies, government authorities, healthcare providers, police or other law enforcement agencies, that holds information (including personal information) related to information on this application form and/or accompanying documentation to disclose that information to Immigration New Zealand so that they can:

• make a decision on this application
• answer enquiries about my immigration status once my application has been decided.

By selecting yes to this declaration you agree to the above items contained within this form.

By selecting yes and clicking Send you agree that this constituents a digital signature

Yes/No

Yes No

Today's date

Work Visa

Application Form

Personal details

Family/last name as shown in your passport

Given/first name as shown in your passport

Prefererred title

Other names your are known by or have ever been nown by

Gender

Date of birth

Town city of birth

Country of birth

Passport number

Passport Country

Passport date of expiry

Passport issue date

Other citizenships you hold

Parnership status

Contact details

Your current residential address:

Address

Telephone (landline)

Telephone (mobile)

If you are currently in New Zealand, your most recent overseas address.

Address

Do you authorise the person stated above to act on your behalf?

Yes/No

Yes No

Do you authorise all other licensed immigration advisers or persons exempt from licensing who work for the organisation named above to act on your behalf (if applicable)?

Yes/No

Yes - Note: the person identifed above will receive all communication from Immigration New Zealand. No - Only the person indicated above may act on my behalf.

Have you received immigration advice on this application?

Yes/No

Yes - Make sure that your immigration adviser completes the section on Immigration adviser’s details’. No

Names and addresses of any friends, relatives, or contacts you have in New Zealand (if applicable).

Name

Address

Relationship

Date of Birth (if known)

Name

Address

Relationship

Date of Birth (if known)

Your Health

Do you have tuberculosis (TB)?

Yes/No

Yes No

Do you have any medical condition that requires, or may require, one of the following during your stay in New Zealand?

Renal dialysis

Yes/No

Yes No

Hospital care

Yes/No

Yes No

Residential care

Yes/No

Yes No

Residential care is defned as in-patient care for people with psychiatric, sensory or intellectual disabilities or live-in facilities for the aged.

If you have answered Yes to any of the questions above, provide details

Are you pregnant?

Yes/No

Yes No

Date you are due to give birth

If you intend to give birth in New Zealand, please indicate how the cost of maternity health services will be paid for and provide the relevant evidence.

Yes/No

Upload Sponsorship Form for Temporary Entry (INZ 1025) (if applicable)

Sponsorship Form for Temporary Entry (INZ 1025

Your character

Yes/No

Yes No

Are you currently under investigation for any offence in any country?

Yes/No

Yes No

Are you currently wanted for questioning for any offence in any country?

Yes/No

Yes No

Are you currently facing charges for any offence in any country?

Yes/No

Yes No

Have you ever been excluded from any country, excluding New Zealand?

Yes/No

Yes No

Have you ever been refused entry from any country, excluding New Zealand?

Yes/No

Yes No

Have you ever been removed or deported from any country, excluding New Zealand?

Yes/No

Yes No

Have you ever been refused a visa/permit to visit, work, study or reside in any country?

Yes/No

Yes No

Have you ever been a member of, or adhered to, any terrorist organisation?

Yes/No

Yes No

Yes/No

Yes No

If you have answered yes to any of the questions above give full details. This includes full details of any charges, convictions and the sentence or penalty imposed.

More Information

File Upload

Employment and Qualification

List all periods of previous employment, including self-employment and employment outside New Zealand.

Date from

Date to

Name of employer

Location

Occupation/Job title

Date from

Date to

Name of employer

Location

Occupation/Job title

Date from

Date to

Name of employer

Location

Occupation/Job title

Give details of all qualifcations you hold. If you have no qualifcations, write ‘No qualifcations’.

Name of qualification

Date obtained

Institution where gained

Name of qualification

Date obtained

Institution where gained

Name of qualification

Date obtained

Institution where gained

Declaration by applicant

I have provided true and correct answers to the questions in this form.

I understand that if false or misleading information is submitted, my application may be declined without further warning.

I agree to tell Immigration New Zealand about any changes to my circumstances (including a change in my employment or partnership status) that occur after making this application.

I agree to leave New Zealand before my visa expires. If I remain in New Zealand after my visa has expired, I may be deported by Immigration New Zealand.

I agree that if I am not entitled to free health care in New Zealand, I will pay for any health care or medical assistance I may require in New Zealand.

By selecting yes to this declaration you agree to the above items contained within this form.

By selecting yes and clicking Send you agree that this constituents a digital signature

Yes/No

Yes No

Today's Date