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Silver Fern Questionnaire.html
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Silver Fern Questionnaire.html
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<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Strict//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-strict.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head id="ctl00_Head1"><title>
Silver Fern Questionnaire
</title><link href="../../../Content/css/style.css" type="text/css" rel="stylesheet" /><link href="../../../Content/css/style_general.css" type="text/css" rel="stylesheet" /><link href="../../../Content/css/SilverFern.css" type="text/css" rel="stylesheet" /><link href="../../../Content/css/style_cssm.css" type="text/css" rel="stylesheet" /><link href="../../../Content/css/import.css" type="text/css" rel="stylesheet" /><link href="../../../Content/css/import_cssm.css" type="text/css" rel="stylesheet" /><link href="../../../Content/css/import_general.css" type="text/css" rel="stylesheet" /><link rel="stylesheet" type="text/css" href="../../../Content/themes/smoothness/ui.all.css" /><link rel="stylesheet" type="text/css" href="../../../Content/css/ui-smoothness.datepick.css" />
<script src="/SILVERFERN/Content/js/jquery-1.3.2.js"> type="text/javascript"></script>
<script src="/SILVERFERN/Content/js/jquery-ui-1.7.2.custom.min.js"> type="text/javascript"></script>
<script src="/SILVERFERN/Content/js/jquery.blockUI.js"> type="text/javascript"></script>
<script src="/SILVERFERN/Content/js/jquery.form.js"> type="text/javascript"></script>
<script src="/SILVERFERN/Content/js/ui.core.js"> type="text/javascript"></script>
<script src="/SILVERFERN/Content/js/jquery.datepick.js"> type="text/javascript"></script>
<script src="/SILVERFERN/Content/js/NZISSilverFern.js"> type="text/javascript"></script>
</head>
<body>
<div class="onlineapplicationwizardpage">
<!-- top blue banner starts -->
<table width="100%" cellpadding="0" cellspacing="0" border="0" class="block">
<tr valign="middle">
<td width="1" class="topbannerpop" height="46"><a href="#pagecontent"><img src="/Images/brand/sp.gif" width="1" height="46" alt="Skip to main content for this page" border="0"></a></td>
<td class="topbannerpop" width="35">
<a href="../../../home/index" id="ctl00_HeaderUC1_fernAnchor" title="Silver Fern Job Search visa Online Application Home Page">
<img src="/Images/brand/fern_topleft.gif" width="35" height="18" alt="" title="Silver Fern Job Search visa Online Application" border="0"></a></td>
<td class="topbannerpop"><h1>Silver Fern Job Search visa Online Application</h1></td>
<td width="100" class="popright"> </td>
</tr>
</table><!-- top blue banner ends -->
<!-- breadcrumb stripe row starts -->
<table width="100%" cellpadding="0" cellspacing="0" border="0" class="block">
<tr valign="middle">
<td class="breadcrumb"><a href="../../../home/index" id="ctl00_HeaderUC1_homeAnchor" title="Silver Fern Homepage" style="font-weight: bold">Home</a></td>
<td class="breadclose" align="right">
<a href="http://formshelp.immigration.govt.nz/onlineservices/silverfern/termsandconditions.htm" id="termsandcondition" target="_blank" title="Link opens in a new window" onclick="window.open('http://formshelp.immigration.govt.nz/onlineservices/silverfern/termsandconditions.htm','newpopuppopup','toolbar=no ,menubar=no ,location=no ,status=yes ,directories=no ,scrollbars= yes ,resizable= yes ,width=600 ,height=434'); return false" >Terms and Conditions</a>
<img src="../../../Images/brand/navlink_seperator_short.gif" />
<script language="JavaScript" type="text/javascript">
if (window.opener) { document.write('<a href="javascript:window.close();">Close Window</a> '); }
</script>
</td>
</tr>
</table>
<table width="100%" cellspacing="0" cellpadding="0" border="0">
<tr valign="middle">
<td>
<br>
<h2 style="margin-left: 20px">
<span id="ctl00_headingLabel"></span>
</h2>
</td>
</tr>
<tr valign="top">
<td class="bodycontent">
<a name="pagecontent"></a>
<div class="content">
<script type="text/javascript">
$(document).ready(function() {
var options = {
//target: '#wizardpage', // target element(s) to be updated with server response
beforeSubmit: showRequest, // pre-submit callback
success: showResponse, // post-submit callback
error: ErrorDisplay
};
$('#wizardpage form:first').ajaxForm(options);
$('.DateTimePicker').datepick({ useThemeRoller : true, changeMonth: false, changeYear: false, showBigPrevNext: true, stepBigMonths: 12,
showOn: 'both', buttonImageOnly: true, buttonImage: '../../../Images/calendar.gif', duration: 'normal', closeAtTop: false, hideIfNoPrevNext: true, mandatory: true, onSelect: SelectDate, beforeShow: SetUpMaxMinDateForDatePicker
});
});
</script>
<p>
The information you enter into this application form will be used to determine your eligibility for the <a href="http://www.immigration.govt.nz/migrant/stream/work/silverfern/jobsearch" id="immigrationAnchor1" target="_blank" title="Link opens in a new window" onclick="window.open('http://www.immigration.govt.nz/migrant/stream/work/silverfern/jobsearch','newpopup','toolbar=yes ,menubar=yes ,location=yes ,status=yes ,directories=yes ,scrollbars= yes ,resizable= yes ,width=600 ,height=434'); return false" >Silver Fern Job Search visa</a>. There are a limited number of places available in the <a href="http://www.immigration.govt.nz/migrant/stream/work/silverfern/jobsearch" id="immigrationAnchor1" target="_blank" title="Link opens in a new window" onclick="window.open('http://www.immigration.govt.nz/migrant/stream/work/silverfern/jobsearch','newpopuppopup','toolbar=no ,menubar=no ,location=no ,status=yes ,directories=no ,scrollbars= yes ,resizable= yes ,width=600 ,height=434'); return false" >Silver Fern quota</a>, your place is only secured once you submit and if required pay for your application.
</p>
<p>
After you have completed the online stage of the application you will be required to submit <a href="http://www.immigration.govt.nz/migrant/stream/work/silverfern/jobsearch/#evid" id="evidence" target="_blank" title="Link opens in a new window" onclick="window.open('http://www.immigration.govt.nz/migrant/stream/work/silverfern/jobsearch/#evid','newpopup','toolbar=yes ,menubar=yes ,location=yes ,status=yes ,directories=yes ,scrollbars= yes ,resizable= yes ,width=600 ,height=434'); return false" >evidence</a> you meet the Silver Fern Job Search visa requirements.
</p>
<div id="wizardpage" class="onlineapplicationwizardpage">
<form action="/SILVERFERN/Questionnaire/Details/PersonalDetails/1666659" method="post">
<br>
<table width="100%" border="0" cellpadding="0" cellspacing="0">
<tr style="padding-bottom: 8px; padding-top: 8px">
<td>
<input type="submit" name="submitButton" accesskey="P" alternatetext="Previous (ALT + P)" value="Previous" style="font: 'Trebuchet MS'; font-weight:bold; color:White; text-transform: capitalize; background-color: #3399cc; border: 1pt ridge lightgrey; width:80px; cursor:pointer;";/>
</td>
<td align="center">
<input id="saveButton" name="submitButton" accesskey="S" alternatetext="Validate & Save (ALT + S)" type="submit" value="Validate & Save" style="font: 'Trebuchet MS'; font-weight:bold; color:White; text-transform: capitalize; background-color: #3399cc; border: 1pt ridge lightgrey; width:120px; cursor:pointer;";/>
<input id="completeLaterImageButton" name="submitButton" accesskey="L" alternatetext="Complete Later (ALT + L)" type="submit" value="Complete Later" style="font: 'Trebuchet MS'; font-weight:bold; color:White; text-transform: capitalize; background-color: #3399cc; border: 1pt ridge lightgrey; width:120px; cursor:pointer;";/>
</td>
<td align="right">
<input type="submit" name="submitButton" accesskey="N" alternatetext="Next (ALT + N)" value="Next" style="font: 'Trebuchet MS'; font-weight:bold; color:White; text-transform: capitalize; background-color: #3399cc; border: 1pt ridge lightgrey; width:60px; cursor:pointer;";/>
</td>
</tr>
</table>
<table width="100%" border="0" cellpadding="0" cellspacing="0" id=Table2>
<tr>
<td valign="top" colspan="3">
<table width="100%">
<tr>
<td align="left">
<table border="0" cellpadding="2" cellspacing="0" width="250">
<tr>
<td nowrap align="left" colspan =2>
<label class="smalltext">You must complete all fields with a </label>
<span title="Field is mandatory"
style="font-family: Arial; font-size: small; color: #AA0000">*</span><label class="smalltext"> next to them.</label>
</td>
</tr>
<tr>
<td nowrap align="left">
<img id="8_errorImage" Title="Section contains errors" src="../../../Images/Tabcontrol/icon_error.gif" alt="Error" style="border-width:0px;height:13px;width:13px;" />
</td>
<td align="left"><label for="errorImage" class="smalltext">The section is incomplete and/or contains errors.</label>
</td>
</tr>
<tr>
<td nowrap align="left">
<img id="8_okImage" title="Section is complete and has no errors" src="../../../Images/Tabcontrol/icon_tick.gif" alt="Clear" style="border-width:0px;height:13px;width:13px;" />
</td>
<td align="left"><label for="okImage" class="smalltext">Section is complete and has no errors.</label>
</td>
</tr>
</table>
</td>
</tr>
</table>
</td>
</tr>
</table>
<div><br><table cellspacing="0" cellpadding="0" width="100%" border="0" bordercolor="red" class="tabtable"><tr valign="bottom"><td><div class="tabcontainer"><div class=current><img src="../../../Images/Tabcontrol/icon_tick.gif" border="0" width="13" height="13" alt="Completed" title="Completed" /> <input type="submit" name="tabButton_PersonalDetails" value="Personal Details"class="newtabbuttonon" title="Personal Details" /></div><div class=innercontainer><img src="../../../Images/Tabcontrol/icon_error.gif" border="0" width="13" height="13" alt="Contains Errors" title="Contains Errors" /> <input type="submit" name="tabButton_SilverFernSpecific" value="Silver Fern Requirements"class="newtabbutton" title="Questions Specific to your Silver Fern application" /></div><div class=innercontainer><img src="../../../Images/Tabcontrol/icon_error.gif" border="0" width="13" height="13" alt="Contains Errors" title="Contains Errors" /> <input type="submit" name="tabButton_MedicalConditions" value="Health"class="newtabbutton" title="Medical Details" /></div><div class=innercontainer><img src="../../../Images/Tabcontrol/icon_error.gif" border="0" width="13" height="13" alt="Contains Errors" title="Contains Errors" /> <input type="submit" name="tabButton_Character" value="Character"class="newtabbutton" title="Character" /></div><div class=innercontainer><img src="../../../Images/Tabcontrol/icon_error.gif" border="0" width="13" height="13" alt="Contains Errors" title="Contains Errors" /> <input type="submit" name="tabButton_ContactDetails" value="Contact Details"class="newtabbutton" title="Contact Details" /></div></div></div></td></tr></table>
<div class="blockme">
<table id="wizardPageHeader_nav_SectionHeaderTable" cellspacing="0" cellpadding="2" width="100%" border="0" class="sitetable"><tr valign="top"><td width="20"> </td><td valign="top"><h2>Personal Details</h2></td><td width="20"> </td></tr></table>
<table id="entryTable" cellpadding="2" cellspacing="0" border="0" width="100%" class="sitetable">
<tbody>
<tr valign="top">
<td width="20">
</td>
<td>
<table width="100%">
<tbody>
<tr>
<td colspan="3">
<h3>
Identification:</h3>
</td>
</tr>
<tr>
<td width="35%">
Family name
<br />
(as in passport)
</td>
<td width = "5%"></td>
<td width="35%" nowrap="nowrap">
<input id="FamilyName_Value" maxlength="50" name="FamilyName.Value" type="text" value="XXX" />
<span style="font-family: 'Arial', Times, serif; font-size: large; color: #800000">*</span>
</td>
<td>
<span class="SilverFernErrorMessage"></span>
</td>
</tr>
<tr>
<td>
Given name 1
<br>
(as in passport)
</td>
<td width = "5%"></td>
<td width="35%" nowrap="nowrap">
<input id="Given1_Value" maxlength="30" name="Given1.Value" type="text" value="XXX" />
<span style="font-family: 'Arial', Times, serif; font-size: large; color: #800000">*</span>
</td>
<td>
<span class="SilverFernErrorMessage"></span>
</td>
</tr>
<tr>
<td>
Given name 2
<br>
(as in passport)
</td>
<td width = "5%"></td>
<td width="35%" nowrap="nowrap">
<input id="Given2_Value" maxlength="30" name="Given2.Value" type="text" value="" />
</td>
<td>
<span class="SilverFernErrorMessage"></span>
</td>
</tr>
<tr>
<td>
Given name 3
</td>
<td width = "5%"></td>
<td width="35%" nowrap="nowrap">
<input id="Given3_Value" maxlength="30" name="Given3.Value" type="text" value="" />
</td>
<td>
<span class="SilverFernErrorMessage"></span>
</td>
</tr>
<tr>
<td>
<span id="10_otherNamesLabel">Please state any other names you are or have ever been known by:</span>
</td>
<td width = "5%"></td>
<td width="35%" nowrap="nowrap">
<input id="OtherNames_Value" maxlength="255" name="OtherNames.Value" type="text" value="" />
</td>
<td>
<span class="SilverFernErrorMessage"></span>
</td>
</tr>
<tr>
<td>
Preferred title
</td>
<td width = "5%"></td>
<td width="35%" nowrap="nowrap">
<select id="SalutationId_Value" name="SalutationId.Value"><option value="">Select an option</option>
<option value="1">Mr </option>
<option value="2">Mrs</option>
<option value="3">Ms</option>
<option value="4">Miss</option>
<option value="5">Dr</option>
<option value="6">Other</option>
</select>
</td>
<td>
<span class="SilverFernErrorMessage"></span>
</td>
</tr>
<tr>
<td>
Gender
</td>
<td width = "5%"></td>
<td width="35%" nowrap="nowrap">
<select id="Gender_Value" name="Gender.Value"><option value="">Select an option</option>
<option value="M">Male</option>
<option value="F">Female</option>
</select>
<span style="font-family: 'Arial', Times, serif; font-size: large; color: #800000">*</span>
</td>
<td>
<span class="SilverFernErrorMessage"></span>
</td>
</tr>
<tr>
<td>
Date of birth
</td>
<td width = "5%"></td>
<td width="35%" nowrap="nowrap">
<select id="DateOfBirth_Value_Day" name="DateOfBirth.Value.Day" onchange="UpdateDateValue("DateOfBirth.Value")"><option value="blank">...</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select><select id="DateOfBirth_Value_Month" name="DateOfBirth.Value.Month" onchange="UpdateDateValue("DateOfBirth.Value")"><option value="blank">...</option>
<option value="1">January</option>
<option value="2">February</option>
<option value="3">March</option>
<option value="4">April</option>
<option value="5">May</option>
<option value="6">June</option>
<option value="7">July</option>
<option value="8">August</option>
<option value="9">September</option>
<option value="10">October</option>
<option value="11">November</option>
<option value="12">December</option>
</select><select id="DateOfBirth_Value_Year" name="DateOfBirth.Value.Year" onchange="UpdateDateValue("DateOfBirth.Value")"><option value="blank">...</option>
<option value="1980">1980</option>
<option value="1981">1981</option>
<option value="1982">1982</option>
<option value="1983">1983</option>
<option value="1984">1984</option>
<option value="1985">1985</option>
<option value="1986">1986</option>
<option value="1987">1987</option>
<option value="1988">1988</option>
<option value="1989">1989</option>
<option value="1990">1990</option>
<option value="1991">1991</option>
<option value="1992">1992</option>
<option value="1993">1993</option>
<option value="1994">1994</option>
<option value="1995">1995</option>
<option value="1996">1996</option>
</select><input id='DateOfBirth.Value' name='DateOfBirth.Value' class='DateTimePicker' type='hidden' value = '23 January 1985'/><input id='DateOfBirth.Value_maxDate' name='DateOfBirth.Value_maxDate' type='hidden' value = '03 November 1996'/><input id='DateOfBirth.Value_minDate' name='DateOfBirth.Value_minDate' type='hidden' value = '04 November 1980'/>
<span style="font-family: 'Arial', Times, serif; font-size: large; color: #800000">*</span>
</td>
<td>
<span class="SilverFernErrorMessage"></span>
</td>
</tr>
<tr>
<td>
Country of birth
</td>
<td width = "5%"></td>
<td width="35%" nowrap="nowrap">
<select id="CountryOfBirthId_Value" name="CountryOfBirthId.Value"><option value="">Select an option</option>
<option value="4">Afghanistan</option>
<option value="5">Albania</option>
<option value="6">Algeria</option>
<option value="7">American Samoa</option>
<option value="8">Andorra</option>
<option value="9">Angola</option>
<option value="10">Anguilla</option>
<option value="11">Antarctica</option>
<option value="12">Antigua & Barbuda</option>
<option value="13">Argentina</option>
<option value="14">Armenia</option>
<option value="15">Aruba</option>
<option value="16">Australia</option>
<option value="17">Austria</option>
<option value="18">Azerbaijan</option>
<option value="19">Bahamas</option>
<option value="20">Bahrain</option>
<option value="21">Bangladesh</option>
<option value="22">Barbados</option>
<option value="23">Belarus</option>
<option value="24">Belgium</option>
<option value="25">Belize</option>
<option value="26">Benin</option>
<option value="27">Bermuda</option>
<option value="28">Bhutan</option>
<option value="29">Bolivia</option>
<option value="252">Bonaire, Sint Eustatius & Saba</option>
<option value="30">Bosnia & Herzegovina</option>
<option value="31">Botswana</option>
<option value="32">Brazil</option>
<option value="33">British Indian Ocean Territory</option>
<option value="34">Brunei Darussalam</option>
<option value="35">Bulgaria</option>
<option value="36">Burkina Faso</option>
<option value="37">Burundi</option>
<option value="38">Cambodia</option>
<option value="39">Cameroon</option>
<option value="40">Canada</option>
<option value="41">Cape Verde</option>
<option value="42">Cayman Islands</option>
<option value="43">Central African Republic</option>
<option value="44">Chad</option>
<option value="45">Chile</option>
<option value="46">China</option>
<option value="47">Christmas Island</option>
<option value="48">Cocos (Keeling) Island</option>
<option value="49">Colombia</option>
<option value="50">Comoros</option>
<option value="51">Congo</option>
<option value="52">Cook Islands</option>
<option value="53">Costa Rica</option>
<option value="54">Croatia</option>
<option value="55">Cuba</option>
<option value="253">Curacao</option>
<option value="56">Cyprus</option>
<option value="57">Czech Republic</option>
<option value="58">Democratic Republic of Congo</option>
<option value="59">Denmark</option>
<option value="60">Djibouti</option>
<option value="61">Dominica</option>
<option value="62">Dominican Republic</option>
<option value="63">East Timor</option>
<option value="64">Ecuador</option>
<option value="65">Egypt</option>
<option value="66">El Salvador</option>
<option value="67">Equitorial Guinea</option>
<option value="68">Eritrea</option>
<option value="69">Estonia</option>
<option value="70">Ethiopia</option>
<option value="71">Faeroe Islands</option>
<option value="72">Falkland Islands</option>
<option value="73">Federated States of Micronesia</option>
<option value="74">Fiji</option>
<option value="75">Finland</option>
<option value="76">France</option>
<option value="77">French Guiana</option>
<option value="78">French Polynesia</option>
<option value="79">Gabon</option>
<option value="80">Gambia</option>
<option value="81">Georgia</option>
<option value="82">Germany</option>
<option value="83">Ghana</option>
<option value="84">Gibraltar</option>
<option value="85">Great Britain</option>
<option value="86">Greece</option>
<option value="87">Greenland</option>
<option value="88">Grenada</option>
<option value="89">Guadeloupe</option>
<option value="90">Guam</option>
<option value="91">Guatemala</option>
<option value="92">Guinea</option>
<option value="93">Guinea - Bissau</option>
<option value="94">Guyana</option>
<option value="95">Haiti</option>
<option value="96">Honduras</option>
<option value="97">Hong Kong</option>
<option value="98">Hungary</option>
<option value="99">Iceland</option>
<option value="100">India</option>
<option value="101">Indonesia</option>
<option value="102">Iran</option>
<option value="103">Iraq</option>
<option value="104">Ireland</option>
<option value="105">Israel</option>
<option value="106">Italy</option>
<option value="107">Ivory Coast</option>
<option value="108">Jamaica</option>
<option value="109">Japan</option>
<option value="110">Jordan</option>
<option value="111">Kazakhstan</option>
<option value="112">Kenya</option>
<option value="113">Kiribati</option>
<option value="114">Kosovo - UN Mission in</option>
<option value="250">Kosovo - Republic of</option>
<option value="115">Kuwait</option>
<option value="116">Kyrgyzstan</option>
<option value="117">Laos</option>
<option value="118">Latvia</option>
<option value="119">Lebanon</option>
<option value="120">Lesotho</option>
<option value="121">Liberia</option>
<option value="122">Libya</option>
<option value="123">Liechtenstein</option>
<option value="124">Lithuania</option>
<option value="125">Luxembourg</option>
<option value="126">Macau</option>
<option value="127">Macedonia</option>
<option value="128">Madagascar</option>
<option value="129">Malawi</option>
<option value="130">Malaysia</option>
<option value="131">Maldives</option>
<option value="132">Mali</option>
<option value="133">Malta</option>
<option value="134">Marshall Islands</option>
<option value="135">Martinique</option>
<option value="136">Mauritania</option>
<option value="137">Mauritius</option>
<option value="138">Mayotte</option>
<option value="139">Mexico</option>
<option value="140">Moldova</option>
<option value="141">Monaco</option>
<option value="142">Mongolia</option>
<option value="248">Montenegro</option>
<option value="143">Montserrat</option>
<option value="144">Morocco</option>
<option value="145">Mozambique</option>
<option value="146">Myanmar</option>
<option value="147">Namibia</option>
<option value="148">Nauru</option>
<option value="149">Nepal</option>
<option value="150">Netherlands</option>
<option value="151">Netherlands Antilles</option>
<option value="152">New Caledonia</option>
<option value="153">New Zealand</option>
<option value="154">Nicaragua</option>
<option value="155">Niger</option>
<option value="156">Nigeria</option>
<option value="157">Niue</option>
<option value="158">Norfolk Island</option>
<option value="159">North Korea</option>
<option value="160">Northern Mariana Islands</option>
<option value="161">Norway</option>
<option value="162">Oman</option>
<option value="163">Pacific Island Trust Territory</option>
<option value="164">Pakistan</option>
<option value="165">Palau</option>
<option value="166">Palestine</option>
<option value="167">Panama</option>
<option value="168">Papua New Guinea</option>
<option value="169">Paraguay</option>
<option value="170">Peru</option>
<option value="171">Philippines</option>
<option value="172">Pitcairn Islands</option>
<option value="173">Poland</option>
<option value="174">Portugal</option>
<option value="175">Puerto Rico</option>
<option value="176">Qatar</option>
<option value="177">Reunion</option>
<option value="178">Romania</option>
<option value="179">Russia</option>
<option value="180">Rwanda</option>
<option value="181">Samoa</option>
<option value="182">San Marino</option>
<option value="183">Sao Tome & Principe</option>
<option value="184">Saudi Arabia</option>
<option value="185">Senegal</option>
<option value="247">Serbia</option>
<option value="249">Serbia & Montenegro</option>
<option value="186">Seychelles</option>
<option value="187">Sierra Leone</option>
<option value="188">Singapore</option>
<option value="254">Sint Maarten </option>
<option value="189">Slovakia</option>
<option value="190">Slovenia</option>
<option value="191">Solomon Islands</option>
<option value="192">Somalia</option>
<option value="193">South Africa</option>
<option value="194">South Korea</option>
<option value="195">South Pacific commission</option>
<option value="251">South Sudan</option>
<option value="196">Soviet Union</option>
<option value="197">Spain</option>
<option value="198">Sri Lanka</option>
<option value="199">St Helena</option>
<option value="200">St Kitts - Nevis</option>
<option value="201">St Lucia</option>
<option value="202">St Pierre & Miquelon</option>
<option value="203">St Vincent and the Grenadines</option>
<option value="204">Sth Georgia & Sandwich Islands</option>
<option value="205">Sudan</option>
<option value="206">Suriname</option>
<option value="207">Swaziland</option>
<option value="208">Sweden</option>
<option value="209">Switzerland</option>
<option value="210">Syria</option>
<option value="211">Taiwan</option>
<option value="212">Tajikistan</option>
<option value="213">Tanzania</option>
<option value="214">Thailand</option>
<option value="215">Timor Leste</option>
<option value="216">Togo</option>
<option value="217">Tokelau</option>
<option value="218">Tonga</option>
<option value="219">Trinidad and Tobago</option>
<option value="220">Tunisia</option>
<option value="221">Turkemenistan</option>
<option value="222">Turkey</option>
<option value="223">Turks and Caicos Islands</option>
<option value="224">Tuvalu</option>
<option value="225">Uganda</option>
<option value="226">Ukraine</option>
<option value="227">United Arab Emirates</option>
<option value="228">United Nations</option>
<option value="229">United States of America</option>
<option value="230">Uruguay</option>
<option value="231">US Outlying Islands</option>
<option value="232">US Pacific Islands</option>
<option value="233">Uzbekistan</option>
<option value="234">Vanuatu</option>
<option value="235">Vatican City</option>
<option value="236">Venezuela</option>
<option value="237">Vietnam</option>
<option value="238">Virgin Islands, British</option>
<option value="239">Virgin Islands, USA</option>
<option value="240">Wallis and Futuna</option>
<option value="241">Western Sahara</option>
<option value="242">Yemen</option>
<option value="243">Yugoslavia</option>
<option value="244">Zambia</option>
<option value="245">Zimbabwe</option>
</select>
<span style="font-family: 'Arial', Times, serif; font-size: large; color: #800000">*</span>
</td>
<td>
<span class="SilverFernErrorMessage"></span>
</td>
</tr>
</tbody>
</table>
<table width="100%">
<tbody>
<tr>
<td colspan="3">
<h3>
Passport:</h3>
</td>
</tr>
<tr>
<td colspan="3">
<p>
Please enter the details of the passport you intend to use to travel to New Zealand. You will be required to send this passport to Immigration New Zealand along with your other documentation after your application is submitted.
</p>
</td>
</tr>
<tr>
<td width="35%">
Passport Number
</td>
<td width="5%">
</td>
<td width="35%" nowrap="nowrap">
<input id="PassportNumber_Value" maxlength="15" name="PassportNumber.Value" type="text" value="XXXXXXXX" />
<span style="font-family: 'Arial', Times, serif; font-size: large; color: #800000">*</span>
</td>
<td>
<span class="SilverFernErrorMessage"></span>
</td>
</tr>
<tr>
<td width="35%" nowrap="nowrap">
Please re-enter Passport Number
</td>
<td width="5%">
</td>
<td width="35%" nowrap="nowrap">
<input id="PassportNumberConfirm_Value" maxlength="15" name="PassportNumberConfirm.Value" type="text" value="E08655980" />
<span style="font-family: 'Arial', Times, serif; font-size: large; color: #800000">*</span>
</td>
<td>
<span class="SilverFernErrorMessage"></span>
</td>
</tr>
<tr>
<td>
Passport Country / Citizenship
</td>
<td width="5%">
</td>
<td width="35%" nowrap="nowrap">
<select id="CountryId_Value" name="CountryId.Value"><option value="">Select an option</option>
<option value="4">Afghanistan</option>
<option value="5">Albania</option>
<option value="6">Algeria</option>
<option value="8">Andorra</option>
<option value="9">Angola</option>
<option value="10">Anguilla</option>
<option value="12">Antigua & Barbuda</option>
<option value="13">Argentina</option>
<option value="14">Armenia</option>
<option value="15">Aruba</option>
<option value="16">Australia</option>
<option value="17">Austria</option>
<option value="18">Azerbaijan</option>
<option value="19">Bahamas</option>
<option value="20">Bahrain</option>
<option value="21">Bangladesh</option>
<option value="22">Barbados</option>
<option value="23">Belarus</option>
<option value="24">Belgium</option>
<option value="25">Belize</option>
<option value="26">Benin</option>
<option value="27">Bermuda</option>
<option value="28">Bhutan</option>
<option value="29">Bolivia</option>
<option value="30">Bosnia & Herzegovina</option>
<option value="31">Botswana</option>
<option value="32">Brazil</option>
<option value="34">Brunei Darussalam</option>
<option value="35">Bulgaria</option>
<option value="36">Burkina Faso</option>
<option value="37">Burundi</option>
<option value="38">Cambodia</option>
<option value="39">Cameroon</option>
<option value="40">Canada</option>
<option value="41">Cape Verde</option>
<option value="42">Cayman Islands</option>
<option value="43">Central African Republic</option>
<option value="44">Chad</option>
<option value="45">Chile</option>
<option value="46">China</option>
<option value="49">Colombia</option>
<option value="50">Comoros</option>
<option value="51">Congo</option>
<option value="53">Costa Rica</option>
<option value="54">Croatia</option>
<option value="55">Cuba</option>
<option value="56">Cyprus</option>
<option value="57">Czech Republic</option>
<option value="58">Democratic Republic of Congo</option>
<option value="59">Denmark</option>
<option value="60">Djibouti</option>
<option value="61">Dominica</option>
<option value="62">Dominican Republic</option>
<option value="64">Ecuador</option>
<option value="65">Egypt</option>
<option value="66">El Salvador</option>
<option value="67">Equitorial Guinea</option>
<option value="68">Eritrea</option>
<option value="69">Estonia</option>
<option value="70">Ethiopia</option>
<option value="71">Faeroe Islands</option>
<option value="73">Federated States of Micronesia</option>
<option value="74">Fiji</option>
<option value="75">Finland</option>
<option value="76">France</option>
<option value="79">Gabon</option>
<option value="80">Gambia</option>
<option value="81">Georgia</option>
<option value="82">Germany</option>
<option value="83">Ghana</option>
<option value="85">Great Britain</option>
<option value="86">Greece</option>
<option value="87">Greenland</option>
<option value="88">Grenada</option>
<option value="89">Guadeloupe</option>
<option value="90">Guam</option>
<option value="91">Guatemala</option>
<option value="92">Guinea</option>
<option value="93">Guinea - Bissau</option>
<option value="94">Guyana</option>
<option value="95">Haiti</option>
<option value="96">Honduras</option>
<option value="97">Hong Kong</option>
<option value="98">Hungary</option>
<option value="99">Iceland</option>
<option value="100">India</option>
<option value="101">Indonesia</option>
<option value="102">Iran</option>
<option value="103">Iraq</option>
<option value="104">Ireland</option>
<option value="105">Israel</option>
<option value="106">Italy</option>
<option value="107">Ivory Coast</option>
<option value="108">Jamaica</option>
<option value="109">Japan</option>
<option value="110">Jordan</option>
<option value="111">Kazakhstan</option>
<option value="112">Kenya</option>
<option value="113">Kiribati</option>
<option value="114">Kosovo - UN Mission in</option>
<option value="250">Kosovo - Republic of</option>
<option value="115">Kuwait</option>
<option value="116">Kyrgyzstan</option>
<option value="117">Laos</option>
<option value="118">Latvia</option>
<option value="119">Lebanon</option>
<option value="120">Lesotho</option>
<option value="121">Liberia</option>
<option value="122">Libya</option>
<option value="123">Liechtenstein</option>
<option value="124">Lithuania</option>
<option value="125">Luxembourg</option>
<option value="126">Macau</option>
<option value="127">Macedonia</option>
<option value="128">Madagascar</option>
<option value="129">Malawi</option>
<option value="130">Malaysia</option>
<option value="131">Maldives</option>
<option value="132">Mali</option>
<option value="133">Malta</option>
<option value="134">Marshall Islands</option>
<option value="135">Martinique</option>
<option value="136">Mauritania</option>
<option value="137">Mauritius</option>
<option value="138">Mayotte</option>
<option value="139">Mexico</option>
<option value="140">Moldova</option>
<option value="141">Monaco</option>
<option value="142">Mongolia</option>
<option value="248">Montenegro</option>
<option value="143">Montserrat</option>
<option value="144">Morocco</option>
<option value="145">Mozambique</option>
<option value="146">Myanmar</option>
<option value="147">Namibia</option>
<option value="148">Nauru</option>
<option value="149">Nepal</option>
<option value="150">Netherlands</option>
<option value="151">Netherlands Antilles</option>
<option value="153">New Zealand</option>
<option value="154">Nicaragua</option>
<option value="155">Niger</option>
<option value="156">Nigeria</option>
<option value="159">North Korea</option>
<option value="160">Northern Mariana Islands</option>
<option value="161">Norway</option>
<option value="162">Oman</option>
<option value="164">Pakistan</option>
<option value="165">Palau</option>
<option value="166">Palestine</option>
<option value="167">Panama</option>
<option value="168">Papua New Guinea</option>
<option value="169">Paraguay</option>
<option value="170">Peru</option>
<option value="171">Philippines</option>
<option value="172">Pitcairn Islands</option>
<option value="173">Poland</option>
<option value="174">Portugal</option>
<option value="175">Puerto Rico</option>
<option value="176">Qatar</option>
<option value="177">Reunion</option>
<option value="178">Romania</option>
<option value="179">Russia</option>
<option value="180">Rwanda</option>
<option value="181">Samoa</option>
<option value="182">San Marino</option>
<option value="183">Sao Tome & Principe</option>
<option value="184">Saudi Arabia</option>
<option value="185">Senegal</option>
<option value="247">Serbia</option>
<option value="249">Serbia & Montenegro</option>
<option value="186">Seychelles</option>
<option value="187">Sierra Leone</option>
<option value="188">Singapore</option>
<option value="189">Slovakia</option>
<option value="190">Slovenia</option>
<option value="191">Solomon Islands</option>
<option value="192">Somalia</option>
<option value="193">South Africa</option>
<option value="194">South Korea</option>
<option value="195">South Pacific commission</option>
<option value="251">South Sudan</option>
<option value="196">Soviet Union</option>
<option value="197">Spain</option>
<option value="198">Sri Lanka</option>
<option value="200">St Kitts - Nevis</option>
<option value="201">St Lucia</option>
<option value="203">St Vincent and the Grenadines</option>
<option value="205">Sudan</option>
<option value="206">Suriname</option>
<option value="207">Swaziland</option>
<option value="208">Sweden</option>
<option value="209">Switzerland</option>
<option value="210">Syria</option>
<option value="211">Taiwan</option>
<option value="212">Tajikistan</option>
<option value="213">Tanzania</option>
<option value="214">Thailand</option>
<option value="215">Timor Leste</option>
<option value="216">Togo</option>
<option value="218">Tonga</option>
<option value="219">Trinidad and Tobago</option>
<option value="220">Tunisia</option>
<option value="221">Turkemenistan</option>
<option value="222">Turkey</option>
<option value="224">Tuvalu</option>
<option value="225">Uganda</option>
<option value="226">Ukraine</option>
<option value="227">United Arab Emirates</option>
<option value="228">United Nations</option>
<option value="229">United States of America</option>
<option value="230">Uruguay</option>
<option value="233">Uzbekistan</option>
<option value="234">Vanuatu</option>
<option value="235">Vatican City</option>
<option value="236">Venezuela</option>
<option value="237">Vietnam</option>
<option value="241">Western Sahara</option>
<option value="242">Yemen</option>
<option value="243">Yugoslavia</option>
<option value="244">Zambia</option>
<option value="245">Zimbabwe</option>
</select>
<span style="font-family: 'Arial', Times, serif; font-size: large; color: #800000">*</span>
</td>
<td>
<span class="SilverFernErrorMessage"></span>
</td>
</tr>
<tr>
<td>
Passport Expiry Date
</td>
<td width="5%">
</td>
<td width="35%" nowrap="nowrap">
<select id="DateOfExpiry_Value_Day" name="DateOfExpiry.Value.Day" onchange="UpdateDateValue("DateOfExpiry.Value")"><option value="blank">...</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select><select id="DateOfExpiry_Value_Month" name="DateOfExpiry.Value.Month" onchange="UpdateDateValue("DateOfExpiry.Value")"><option value="blank">...</option>
<option value="1">January</option>
<option value="2">February</option>
<option value="3">March</option>
<option value="4">April</option>
<option value="5">May</option>
<option value="6">June</option>
<option value="7">July</option>
<option value="8">August</option>
<option value="9">September</option>
<option value="10">October</option>
<option value="11">November</option>
<option value="12">December</option>
</select><select id="DateOfExpiry_Value_Year" name="DateOfExpiry.Value.Year" onchange="UpdateDateValue("DateOfExpiry.Value")"><option value="blank">...</option>
<option value="2016">2016</option>
<option value="2017">2017</option>
<option value="2018">2018</option>
<option value="2019">2019</option>
<option value="2020">2020</option>
<option value="2021">2021</option>
<option value="2022">2022</option>
<option value="2023">2023</option>
<option value="2024">2024</option>
<option value="2025">2025</option>
<option value="2026">2026</option>
<option value="2027">2027</option>
<option value="2028">2028</option>
<option value="2029">2029</option>
<option value="2030">2030</option>
<option value="2031">2031</option>
<option value="2032">2032</option>
<option value="2033">2033</option>
<option value="2034">2034</option>