New Zealand

Family Name *

First/Given Names *

Country of Birth *

Passport Date of Issue *

Country of Birth *

Gender *

Male

Female

Are you currently, or have you ever been, known by any other names (e.g. alias)? *

Yes

Sex *

Male

Female

Passport Details

Country Passport *

Passport number *

Passport Date of Issue *

Expiration Date *

Are you a citizen of any other country? *

Yes

Second Country of Citizenship *

Third Country of Citizenship (optional)

Does the applicant have any other current passports? *

Yes

Second Country of Passport *

Passport number *

Passport Date of Issue *

Expiration Date *

UPLOAD YOUR PASSPORT

Please upload your passport to continue with your visa application *

Click or drag a file to this area to upload.

Address

Home Address *

City *

Country *

State/Province/Region *

Postcode *

Your purpose of stay in Australia *

Tourist

Business

Transit

E-mail Address *

Telephone Number *

Character Details

Do you have an Australian permanent resident visa that allows you to return to Australia from overseas? *

Yes

Will you be staying in New Zealand? *

Yes

Will you be travelling to New Zealand for medical consultation or treatment? *

Yes

Have you ever been convicted of an offence in any country (including any conviction which is now removed from official records)? *

Yes

Are you currently prohibited from entering New Zealand following deportation from New Zealand in the past? *

Yes

Declaration

I declare that: *

The information provided in this form is complete, correct and up-to-date.

I understand that if any fraudulent documents or false or misleading information has been provided with this application or if I fail to satisfy the Minister of my identity, my application may be refused and I, and any member of my family unit, may become unable to be granted a visa for a specified period of time.

I understand that if my visa ceases to be in effect and I do not hold another visa to remain in Australia at that time, I will be an unlawful non-citizen under the Migration Act 1958. As such, I will be expected to depart from Australia, and be subject to removal under the Migration Act 1958.

I understand that if documents are found to be fraudulent or information to be incorrect after the grant of a visa, the visa may subsequently be cancelled.

I have understood and accept the Terms and Conditions, Privacy Policy, Refund Policy

Applicant Information

Personal information

Passport Details

UPLOAD YOUR PASSPORT

Address

Character Details

Declaration