PRIME VISA SOLUTIONS SKILLED MIGRATION ELIGIBILITY ASSESSMENT

*Your Full Name:	.
*Telephone / cellphone:
*Email Address:
*Residential Address:
*Current Country of Residence:
*Date of Birth:		*Nationality:

Please indicate how well you communicate in English.
Please list any other languages in which you can communicate.
Please indicate country you wish to migrate to. If OTHER please provide country name. Please state when you intend to start process
Do you have relatives in New Zealand?
Please provide the exact relationship to your relatives in NEW ZEALAND		*Please be specific e.g. 'father's brother', 'mother's sister's daughter', etc*
Please provide the ADDRESSES AND HOME CONTACT NUMBER of your NEW ZEALAND relatives
Employment History In completing this form, please provide the details as accurately as you can. List your work history over the last seven years. essential data - no assessment will be done unless provided
*Work 1 (CURRENT JOB)
*Occupation Title:
		Date From: Date To:
Employer Name / Address / Phone / Fax / Email address EMPLOYER CONTACT INFO MUST BE SUPPLIED Duties		EMPLOYER NAME ADDRESS PHONE FAX EMAIL BRIEFLY DESCRIBE CURRENT DUTIES:

Work 2
Occupation Title:
		Date From: Date To:
Main Duties:

Work 3
Occupation Title:
		Date From: Date To:
Main Duties:

Work 4
Occupation Title:
		Date From: Date To:
Main Duties:


Education and Training Please note that we only require information after the age of 15. Begin with the most recent education or training undertaken. The detail here is critical to the accurate assessment of your eligibility. Please give full title of award.
Course 1
Course or Training Program:
Institution or Training Provider:
		Date From: Date To:
Course 2
Course or Training Program:
Institution or Training Provider:
		Date From: Date To:
Course 3
Course or Training Program:
Institution or Training Provider:
		Date From: Date To:

REMITTANCE INSTRUCTIONS		Remit ADMINISTRATION FEE ONLY (1000php) to METROBANK Kamias Quezon City Philippines Account 047-7-047-51657-5 Account Name PRIME VISA SOLUTIONS (S Josef t/as)
AGENT ASSESSMENT FEE (NORMALLY NZD$135) IS FREE SUBJECT TO REMITTANCE OF ADMINISTRATION FEE 1000php
Terms & Conditions By submitting this form I agree to the terms of this e-commerce agreement (contract) - deletion or alteration of the following included terms will result in billing as a non genuine enquiry .
I understand and agree to the following terms. I understand I may also be asked to submit a cv if the information provided in this form is not sufficient. I will supply ALL current work contacts not just an email address ONLY - if I supply no CURRENT employer contact details I will NOT be assessed at FREE agent assessment fee. I have financial capacity to migrate and pay professional assistance fees. I understand FREE ASSESSMENT does not also include administration cost of handling this enquiry and by submitting this form I agree I am liable to remit the fee of NZD$30 converted by Prime Visa to local currency. By submitting this form I agree to the Terms & Conditions stated in this form and my failure to abide by these terms and remit required fee is a breach of contract and e-commerce laws and will be treated and billed as a non genuine enquiry. I understand submission of ANY non-compliant or erroneous or non genuine assessment requests submitted by mistake or due to failure to read the terms or any other excuse whatsoever will result in a time based billing of NZD$150 by the agent concerned plus Prime Visa Administration Charge of NZD$30 (billed as 1000php)

Please carefully check all of your responses, then click the Submit button below.