Identity 个人信息

1. Surname 姓

2. Given Name 名

3. Date of Birth 出生日期

4. Gender 性别

5. Country of Citizenship 国籍

6. Partnership 婚姻状况

7. Please select the preferred IEF contact person 您希望由IEF哪位员工与您联络 *

Contact details 联系方式

8. Contact Mobile 手机

9. Email 邮箱

10. Which city/country do you currently live 当前所在城市/国家

Wechat 微信号

11. Wechat 微信号 *

New Zealand Contact Person 新西兰联络人

12. Name 姓名

13. Relationship to you 与您的关系

14. Address 地址

15. Contact Number 联系电话

16. Email 邮箱

17. Residency 公民信息

Language 语言

If you have already obtained any language test before, such as IELTS, please indicate your test result
如果您已取得任何语言测试成绩，如雅思，请告知您的成绩

18. English test name 英语测试名称

19. Result 成绩

20. Obtained date 测试时间

Education Background 教育背景

21. Name of Institution 学校名称

22. Degree/Course Name 学位/课程名称

23. Completion Date 完成日期

You can click + to include more qualifications
您可点击 + 添加更多学历信息

Employment history 工作经验

24. Position 职位

25. Type of business 所属行业

26. Start date 开始日期

27. End date 结束日期

You can click + to include more work experiences.
您可点击 + 添加更多工作信息

Parents Background 父母信息

28. Relationship to you 与你的关系

29. Name 姓名

30. Contact Number 联系电话

31. Occupation (Position) 职业（选填）

32. Annual salary level (for indication only) 年收入水平（仅供参考）

Financial Background 财务资料

33. Who is going to sponsor your study? What is your relationship? What is his occupation (position) and annual salary level? 谁来资助您的学习？您与其是什么关系？他的职业（职位）和年薪水平是多少？

34. In general, students will need an estimate of $30,000 - $45,000 NZD to support their study each year. Can you please give an estimate that how much money can you provide? 一般来说，学生每年需要大约30,000至45,000新西兰元的资金来支持他们的学习。请您估计您大约可以提供多少资金？

35. Are you able to provide 6 months bank statement with sufficient funds as required by INZ? 您是否能够按照新西兰移民局的要求提供6个月的银行对账单，并提供足够的资金？

36. If there is any special situation you would like to bring up, please make your comments below 如果您有任何特殊情况，请在下方提供详细信息

Health 健康

37. Do you have any medical condition that may affect your application? 您是否有任何可能影响您申请的疾病？

38. Do you have tuberculosis (TB)? 您是否患有肺结核？

39. Have you ever participated in or been exposed to any activity which may have exposed you to a serious infectious disease? 您是否曾经参加或接触过可能使您患有严重传染病的任何活动？

40. Do you take any on-going medication? 您是否在服用任何持续性的药物？

41. If you answer yes to any question above, please provide details 以上问题，您有任何回答“是”，请提供更多详细信息

Character 品格

42. Have you ever been convicted/charged/under investigation for any offences against the law of any country? 您是否曾因违反任何国家/地区的法律而被定罪/指控/接受调查？

43. have you ever been excluded/refused entry/removed or deported from any country? 您是否曾被任何国家排除/拒绝入境/被遣返或驱逐出境？

44. Have you ever been refused a visa by any country including New Zealand? 您是否曾经被包括新西兰在内的任何国家拒绝签证？

45. If you have answered yes to any questions above, please provide details 以上问题，您有任何回答“是”，请提供更多详细信息

About your study plan 关于您的学习计划

46. Which school do you intend to enroll in? Do you have any personal interests or special skills? What are your plans after you graduate? 您打算申请入读哪所学校？您有个人兴趣或特殊技能吗？毕业后有什么计划？

Documentation 文件资料

If possible, please also provide the following documents:
Photocopy of Passport
Graduation Certificate
Academic Result
CV if applicable
IELTS result if applicable

如有可能，请提供以下文件资料：
护照复印件
毕业证
学术成绩单
简历（如有）
雅思成绩单（如有）

Declaration 声明

47. I hereby declare that the information given by me in this application is true and correct to the best of my knowledge.I understand and agree that any false information, misrepresentation, or omission of facts in this application and the application process may be justification for refusal/ decline.I further understand and agree that all information furnished in this application and the application process may be verified as may be necessary. 我特此声明，我在本表格中提供的信息是真实和正确的。我理解并同意，在本表格和整个申请过程中所提供的任何虚假信息，虚假陈述或遗漏事实均可能成为申请被拒绝的原因。我进一步理解并同意在必要时可以查核本表格和申请过程中提供的所有信息。 *

Yes 是 No 否

IEF Limited

address

326 New North Road, Kingsland

phone

09 3772233

Email

[email protected]

Student Evaluation 海外留学评估表

Full Name