Non-resident Enrolment form

Non-resident enrolment form 非居民注册表

Please fill the form in English only. 请使用英文填写表格

Title 稱呼*

MrMrsMsMasterMissDrOther
Title 稱呼*
Other title 其他稱呼

Name 名*
Middle Name
Last name 姓*

Gender 性别*

Male 男Female 女Other 其他
please state your gender 请说明性别*

Today*

DayMonthYear
Date
Date of birth 出生日期*

DayMonthYear
Date
age
Name of authorised person as applicant is under 16
授权人姓名(由于申请人未满16岁)
Authorised person's name*

First NameLast Name
Authorised person's relationship 关系 *

Marital status 婚姻狀態*

Single 单身Married 已婚Divorced 离婚Separated 分居

Country of birth 出生国家*
Place of Birth 出生地*

Ethnicity 种族*

NZ EuropeanMaoriChinese 华人SamoanTonganIndianOther 其他
Please state other ethnicity*

Address 地址*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Postal address same as above? 你的邮寄地址和上面一样吗?*

YesNo
Postal address 邮寄地址*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Occupation 职业*

Mobile phone 手机电话*
Home phone 住家电话
work phone 工作电话
Email 电邮*
example@example.com

Do you agree to receive texts? 您是否同意接收手机短信?*

Yes 同意No 不同意

Do you agree to receive emails? 您是否同意接收电子邮件?*

Yes 同意No 不同意

Smoking status 吸烟状况*

Never 从不抽烟Yes 有Ex-smoker 前吸烟者
Quit date 戒烟日期*

DayMonthYear
Date

Next of kin 紧急联络人*

First Name 名Last Name 姓
Relationship 关系*
Phone 电话*
Email 电邮
example@example.com
Address 地址

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Upload documents 上传图片

Camera 相机File upload 上传文件
Take a photo of your passport front page 拍一张护照首页的照片
Upload a photo of your passport and visa 上传您的护照和签证照片

Cancelof

Signature 签名*

Clear
Should be Empty: