Dependent Visa Eligibility Assessment Form

Full Name

Travel information

1. Country I want to visit

2. I am a

De facto partner of a Citizen / Resident in the country Fiancee Spouse of a Citizen / Resident in the country Parent / Grandparents of New Zealand citizens, residents Dependent child of a Citizen/ Resident in the country

3. Purpose of Visit

Tourism Join my partner / Spouse Meeting family member/s

4. Number of people travelling

5. Adults:

6. Children:

Main Applicant Details

7. Family Name (as in your passport):

8. Given Name (as in your passport):

9. Date of Birth (DD/MM/YYYY):

10. Gender:

Male Female

11. Marital status

12. Children (if any)

13. Citizenship:

14. Passport no:

15. Passport expiry:

16. Email Address:

17. Skype/Yahoo messenger id (if any):

18. Google Hangout

19. I am contactable on

Skype

Viber

IMO

Other

20. Residence Phone :

21. Mobile phone:

22. Current Address-

Other information:

23. I am

Currently employed Currently studying Not employed

Details of other dependents travelling with you

24. Name/s

25. Gender

26. Age

27. Nationality

28. Occuaption

Travel Details

29. Start Date

30. End Date

31. Total duration

32. I have booked my sightseeing/travel /accommodation

33. Details

34. I need help with booking

35. Have you been convicted or currently face criminal charges in this country or overseas?

Yes No

36. Details:

37. Have you been refused a visa or deported from any country ?

Yes No

EdVantage International Consulting Limited

address

Ground Floor, 82 Symonds Street, Grafton, Auckland 1010, New Zealand

phone

+6421909861

Email

[email protected]

Dependent Visa Eligibility Assessment Form

Full Name

1. Country I want to visit

2. I am a

3. Purpose of Visit

4. Number of people travelling

5. Adults:

6. Children:

7. Family Name (as in your passport):

8. Given Name (as in your passport):

9. Date of Birth (DD/MM/YYYY):

10. Gender:

11. Marital status

12. Children (if any)

13. Citizenship:

14. Passport no:

15. Passport expiry:

16. Email Address:

17. Skype/Yahoo messenger id (if any):

18. Google Hangout

19. I am contactable on

20. Residence Phone :

21. Mobile phone:

22. Current Address-

23. I am

24. Name/s

25. Gender

26. Age

27. Nationality

28. Occuaption

29. Start Date

30. End Date

31. Total duration

32. I have booked my sightseeing/travel /accommodation

33. Details

34. I need help with booking

35. Have you been convicted or currently face criminal charges in this country or overseas?

36. Details:

37. Have you been refused a visa or deported from any country ?

38. Details:

39. Are you pregnant or handicapped?:

40. I agree to undergo any medical checks /background or reference checks as required during the application process.

41. Do you or any dependent have any medical issues that need ongoing treatment or care?

42. Details:

43. Finance for Travel and Stay :

44. Details:

45. Relationship to Main applicant

46. Family Name (as in your passport):

47. Given Name (as in your passport):

48. Date of Birth (DD/MM/YYYY):

49. Gender:

50. Citizenship:

51. Phone No:

52. Email address:

53. Partnership details:

54. How did you hear about Us?(referred by)

55. Any other important or relevant information?