Immigration & Employment Specialists

Office 1: Level 2, 5 Brett Avenue, Papatoetoe, Manukau 2104, NZ

Office 2: Suite 2A, Level 2 Albert Plaza Building, 87-89 Albert St, CBD Auckland 1010, NZ
Email : info@addpotentials.com
SKYPE : gbc.addpotentials
URL : www.addpotentials.com
Tel Nos: + 64 (9) 2159306-07
Fax + 64 (9) 3089402

QUESTIONNAIRE
(For Initial Skills Assessment)
Name...Age Sex
Address.Status..
Mobile Phone.................... Email...
Birth Date...Birth Place
Education
Completed Degree/Trade or Vocational Course..
.
Institution, Address
..
Inclusive Dates...

No. of years completed

PRC License Details, if applicable.

.
Paid Employment (with Work Certificates)
Position / Title (1).
Name, Address of Employer
.
Inclusive Dates..
Position / Title (2).
Name, Address of Employer
..
Inclusive Dates..
Position / Title (3).
Name, Address of Employer
..
Inclusive Dates..

Position / Title (4).

Name, Address of Employer
..
Inclusive Dates..
Trainings/License (Drivers/Professional)

Miscellaneous Information
Do you have relatives in New Zealand?Relationship..
Address..
Contact Details.
Qualification of Partner (After High School)
Exact Course..
Institution, Address
..
Inclusive Dates...

No. of years completed

PRC License Details, if applicable.

.
List of all countries with inclusive dates lived in for a total of 12 months or more in the last 10 years.
.
...................................................
.
.

English Proficiency of Principal & Partner (With Certificates)

.
..

List of Family Members including siblings &Partners siblings except deceased

(Name/Age/Gender/Birthdate/Place of Residence)

Visa and other legal information

Have you been granted visa before? ____Yes/____No
Explain
.
Have you been declined, refused entry, or deported? ____Yes/____No
Explain
.
.
Do you have pending legal issues that may prevent you from gaining visa or ?___Yes/___No
Explain
.

I hereby certify that the above information is true and correct.

__________________________
Applicant