ELIGIBILITY QUESTIONNAIRE

Fill out the New Zealand eligibility questionnaire below - a processing fee applies.

IMMagine New Zealand Eligibility Questionnaire

Step 1 of 5

This is not an official Government form but has been designed by us to gather all the information required to assess your eligibility to meet your immigration objective. All information received through this form will be treated in the strictest confidence and will not be passed on to any third party without your express permission.

Assessment Report

How would you like to receive your assessment?

Personal Details - Principal Applicant

Last name

Given names

Male or female?

Date of birth

Country of birth

List all citizenships

Home phone number include country and area code


Country	Area	Home phone number

Work phone number including country and area code


Country	Area	Work phone number

Mobile number

Email address

Marital status

How long have you lived together

Have you ever been divorced?

If divorced, please state when

Postal address

Personal Details - Spouse / Partner

Last name

Given names

Male or female?

Date of birth

Country of birth

List all citizenships

Home phone number include country and area code


Country	Area	Home phone number

Work phone number including country and area code


Country	Area	Work phone number

Mobile number

Email address

Has your partner ever been divorced?

If divorced, please state when

Children (Including all children from previous relationships)

Child 1

Name		Date of birth
Male/Female		Country of residence
Do you have full custody?	Yes	Country of citizenship

Child 2

Name		Date of birth
Male/Female		Country of residence
Do you have full custody?	Yes	Country of citizenship

Child 3

Name		Date of birth
Male/Female		Country of residence
Do you have full custody?	Yes	Country of citizenship

Child 4

Name		Date of birth
Male/Female		Country of residence
Do you have full custody?	Yes	Country of citizenship

Visa Details (Only complete if you are in New Zealand)

Name	Arrival Date	Visa Type	Visa Expiry

Health

Do you or any person included in this application have any current medical condition that requires regular medication, monitoring or care by your GP or Specialist? If yes, please provide details of the condition, date of diagnosis, any treatment and current prognosis
Yes

Details

Have you or any person included in this application had any medical condition for which you/they were referred to a specialist or spent time in hospital?
Yes

Details

Please provide the height and weight of any person included in this application

Name	Height (meters, e.g. 1.85)	Weight (kilograms, e.g. 65)

If you have any additional information that you would like to add, please use the box below.

Step 1 additional notes

Assessment Agreement

As advisers licensed by the New Zealand Government we will be providing you with immigration advice as part of the eligibility assessment process. Furthermore we are obliged to provide you with industry Code of Conduct and Complaints Resolution Policy (these can be downloaded below). By submitting and paying for the online consultation you agree that you will be receiving immigration advice. The assessment fee is NZD$250.00 which can be paid for online by Credit Card once you have completed the form.

Icon Code of Conduct - Click Here>> (103.3 KB)

Icon Complaints Policy - Click Here>> (37.4 KB)

Want to Download the Form?

Download and complete the above PDF version of the form and email this back to us at: info@immagine.co.nz

Icon Eligibility Questionnaire (136.1 KB)

Who is IMMagine NZ?

With a residence success rate higher than 99% and more than 20 years of experience, you are in the right place if you're looking to live and work in New Zealand. We have a team of fully licensed advisors available to assist you with your move. Read more...

Immigration Seminars

If you want to learn more about New Zealand as a migration destination, New Zealand Immigration policy and process see if we have seminars planned for your city. If we don’t, how about registering for a free online e-Seminar? Read more...

Skype Assessment

We know it's sometimes difficult to get to our seminars and if you'd like a one on one assessment in a live environment, you are welcome to request an online Skype video assessment from wherever you are in the world. Read more...