1. Name *

2. Email Address *

3. Phone

4. Your Age

5. Date

6. Date of Birth

7. Partnership status

8. If Married, In Civil Union or Partner: Have you been cohabitating for at least 12 months?

Yes No

9. Number of children

10. Ages of children

11. Country of Citizenship/s

12. What is your English level?

Beginner Intermediate Fluent

13. What is your spouse's English level?

Beginner Intermediate Fluent

14. What is the English level of any children 16+?

Beginner Intermediate Fluent

15. Do you or your spouse/children have any serious health issues? Please provide details.

16. Do any of your children have special education needs?

Yes No

17. Have you or your spouse/children been convicted of any offence? If so provide details.

18. Have you or your spouse/children lived in another country for more than 12 months?

Yes No

Have you or your spouse/children lived in another country for more than 12 months? If Yes:

19. Please provide country/s and date/s

20. Do you have court order/permission of other parent / to decide on country of residence of child?

Yes No

21. Have you ever had a visa declined - from any country? This is critical information - if in doubt always answer yes

Yes No

22. If YES: Please Provide details.

23. Do you intend to include children under 16 from a previous relationship?

Yes No

24. If you wish to include children aged 18 - 24 can you document financial dependency? Children 25+ CANNOT be included in an application.

Yes No

25. What is your occupation?

26. No. of years worked in that occupation?

27. In what country/s was that experience gained?

28. Please attach a full cv listing work experience and exact nature of duties in each role.

29. Do you have an offer of employment in NZ?

Yes No

Do you have an offer of employment in NZ? If Yes:

30. Enter employment location

31. Enter employment occupation

32. Enter employment hourly wage/salary level

33. Have you ever worked in NZ?

Yes No

Have you ever worked in NZ? If Yes:

34. Your work occupation

35. Your work period employment

36. What is your highest qualification?

37. Institution

38. Degree/Certificate Date issued

39. Do you have a qualfication gained in NZ?

Yes No

Do you have a qualfication gained in NZ? If Yes:

40. Qualification

41. Instituition

42. Period of study

43. Does your partner have an offer of skilled employment in NZ?

Yes No

44. Does your partner have a Bachelor Degree?

Does your partner have a Bachelor Degree? If Yes:

45. Enter Qualification

46. Institution

47. Date issued

48. Does your partner have a Postgraduate Qualification?

Yes No

David Mason Recruitment and Immigration Advisory Services (NZ) Ltd

address

Building 7, Unit 25, 15 Accent Drive, East Tamaki, Auckland 2013

phone

092652136

Email

[email protected]

David Mason-QUESTIONNAIRE FORM

Full Name

1. Name *

2. Email Address *

3. Phone

4. Your Age

5. Date

6. Date of Birth

7. Partnership status

8. If Married, In Civil Union or Partner: Have you been cohabitating for at least 12 months?

9. Number of children

10. Ages of children

11. Country of Citizenship/s

12. What is your English level?

13. What is your spouse's English level?

14. What is the English level of any children 16+?

15. Do you or your spouse/children have any serious health issues? Please provide details.

16. Do any of your children have special education needs?

17. Have you or your spouse/children been convicted of any offence? If so provide details.

18. Have you or your spouse/children lived in another country for more than 12 months?

Have you or your spouse/children lived in another country for more than 12 months? If Yes:

19. Please provide country/s and date/s

20. Do you have court order/permission of other parent / to decide on country of residence of child?

21. Have you ever had a visa declined - from any country? This is critical information - if in doubt always answer yes

22. If YES: Please Provide details.

23. Do you intend to include children under 16 from a previous relationship?

24. If you wish to include children aged 18 - 24 can you document financial dependency? Children 25+ CANNOT be included in an application.

25. What is your occupation?

26. No. of years worked in that occupation?

27. In what country/s was that experience gained?

28. Please attach a full cv listing work experience and exact nature of duties in each role.

29. Do you have an offer of employment in NZ?

Do you have an offer of employment in NZ? If Yes:

30. Enter employment location

31. Enter employment occupation

32. Enter employment hourly wage/salary level

33. Have you ever worked in NZ?

Have you ever worked in NZ? If Yes:

34. Your work occupation

35. Your work period employment

36. What is your highest qualification?

37. Institution

38. Degree/Certificate Date issued

39. Do you have a qualfication gained in NZ?

Do you have a qualfication gained in NZ? If Yes:

40. Qualification

41. Instituition

42. Period of study

43. Does your partner have an offer of skilled employment in NZ?

44. Does your partner have a Bachelor Degree?

Does your partner have a Bachelor Degree? If Yes:

45. Enter Qualification

46. Institution

47. Date issued

48. Does your partner have a Postgraduate Qualification?

Does your partner have a Postgraduate Qualification? If Yes;

49. Enter qualification

50. Enter Institution

51. Degree/Certificate Date issued