STUDENT VISA APPLICATION FORM For full-time enrolled Waikato Pathways College & University of Waikato students Complete before your appointment Application Form - read and answer every page and question, then sign and date the last page. Check and update your contact details at www.waikato.ac.nz/student, iwaikato link, then click on the Me tab. Payment of your tuition fees and you must print your Enrolment Agreement(s) to bring to your appointment. Contact Immigration NZ on 0508 558 855 -to find out if you need to submit a new Police or Medical Certificates with this application. Bring to your appointment Your student ID card and passport must be valid for at least three months after the new visa ends. Evidence of financial support for living expenses After paying your tuition fees, show evidence of NZ $7,500 per semester or NZ $15,000 per year plus an extra NZ $1,500 to purchase an airline ticket. Short courses of three months or less or non-semester courses, provide evidence of NZ $1,250 per month plus an extra NZ $1,500 to purchase an airline ticket, after paying your tuition fees. Bank Statements in your name and no more than five days old with at least the last three months transactions obtained and dated one day after paying your tuition fees and stamped by the bank. We must be satisfied that the funds are from a genuine source, you have access to them and they are for the purpose of your living requirements. Term deposits - funds held in a New Zealand bank account only. The statement must show your name, account number, start and maturity date of the term deposit or Scholarship letter - Your letter or Financial Guarantee (in English) from your scholarship provider stating the amount and duration of the scholarship or Sponsorship Form for Temporary Entry - INZ form 1025 completed by a New Zealand citizen or a permanent resident. Academic results and Attendance record - if you are transferring from another New Zealand Institution, provide a copy of your academic results and attendance record from your previous New Zealand institution. Proof of address - only if you are under 18 years at the time of this application. When your application has been accepted We will give you an invoice to take to the Payments Office at the Student Centre. Pay the visa application fee of $195 (Immigration fee of $117 and University of Waikato service fee of $78). Sign your Enrolment Agreement so your enrolment can be completed at the Payments counter. 1
When filling in this form, please print clearly using CAPITAL LETTERS. SECTION A: Personal details Last/Family name: First/Given name: Date of birth: University ID number: Gender (circle one) Male or Female Passport number: Passport expiry date: Visa expiry date: Country of citizenship: Partnership status: (please circle) Never married Married Partner Engaged Separated Divorced Contact details Your Hamilton address: Your e-mail address: Mobile Phone Number: Telephone number: Emergency Contact (please circle) Mother Father Wife Husband Partner Name: Phone number: Course of study Name of your Degree or Study Programme: Are you enrolled in One Semester or Two Semesters (please circle) or until date of Day Month Year Do you receive a scholarship? If yes, name of your scholarship provider or sponsor Visa information what visa do you currently hold? (Circle one) STUDENT (University of Waikato) STUDENT (Other Institution) VISITOR WORK Are you a new University of Waikato student or a returning student? NEW or RETURNING 2
SECTION B: Health Check Do you have pulmonary tuberculosis (TB)? Do you have any medical condition(s) that currently requires or may require medical treatment during your stay in New Zealand such as Renal Dialysis, Hospitalisation Residential care* *Residential care is long term care provided in a live-in facility such as a facility for people with a physical, sensory, intellectual or psychiatric disability or an aged-person s facility. Are you pregnant? Yes* No *If you intend to give birth in New Zealand, you will need to supply evidence of an additional NZ $9,000 to cover your maternity care or evidence that your sponsor will cover these costs. If you have answered yes to any of the above questions, please provide details: Will you be in New Zealand for less than six months? If Yes you do not need to provide a medical certificate or chest X-ray To be completed by all International students Have you ever used intravenous drugs? Have you ever had a blood or blood product transfusion? Have you ever participated in or been exposed to any activity which may have exposed you to a serious infectious disease (such as HIV, or hepatitis B or C) If you have answered Yes to any of the above questions then you must complete a full medical check. List of countries, areas and territories with a low incidence of Tuberculosis (TB) Andorra Antigua and Barbuda Austria Barbados Belgium Bermuda British Virgin Islands Canada Cayman Islands Chile Costa Rica Cuba Cyprus Czech Republic Denmark Dominica Finland France Germany Greece Grenada Iceland Ireland Israel (including the Occupied Palestinian Territory, and including East Jerusalem) Italy Jamaica Jordan Lebanon Libya Liechtenstein Luxembourg Malta Monaco Montserrat Netherlands Antilles Netherland New Zealand s Norway Oman Puerto Rico Saint Kitts and Nevis Saint Lucia San Marino Slovenia Sweden Switzerland Trinidad and Tobago Turks and Caicaos Islands United Arab Emirates United Kingdom United States of America United States Virgin Islands Vatican City 3
To be completed by international students (excluding PhD & Exchange students) Are you from a country that is NOT on the list of countries, areas or territories with a low incidence of TB? (Read list on previous page). Or have you visited a country NOT on that list, for more than three months? Yes Please answer the next question No You do not need to provide a chest X-ray certificate. Please proceed to the next section Have you previously provided a chest X-ray which was issued less than 36 months (3 years) ago? Yes Please answer the next question No You must provide a chest X-ray certificate Since your last visa was granted, have you spent six consecutive months or more in a place that is NOT on the list of countries, areas or territories with a low incidence of TB? (Refer to list on page 3) Yes You must provide a new chest X-ray certificate No You do not need to provide a new chest X-ray certificate To be completed by PhD and Exchange students only Have you submitted a medical certificate which was issued less than 36 months ago? If NO, you must provide a general medical certificate and chest X-ray. If YES, since your last visa was granted, have you spent six consecutive months or more in a place that is NOT on the list of countries, areas or territories with a low incidence of TB? If YES to the above question, then you must submit a chest X-ray. NOTE: If you are required to submit a Medical Certificate or Chest X-ray send this directly to INZ within 15 days. Insurance requirements (Please tick) I agree to arrange and hold insurance which my education provider considers acceptable, from the period of my enrolment until the expiry of my student visa, unless I depart New Zealand earlier. Yes I understand that holding insurance will be a condition of my visa and that I may become liable for deportation if I do not hold insurance, from the period of my enrolment until my visa expires, unless I depart New Zealand earlier. Yes I understand that if I apply for a further visa, I may be required to provide evidence that I held acceptable insurance while in New Zealand, holding the visa that I am currently applying for. Yes 4
SECTION C: Police Check Have you submitted a national Police Certificate previously within the last 24 months (2 years)? Yes If yes, the year of submission: No Immigration NZ will advise you by email if they require a new Medical or Police Certificates or further medical tests before your visa can be processed. You must reply to all emails sent by INZ immediately or your application may be rejected. Have you been convicted, charged or are under investigation for offences against the law of New Zealand or any other country? Have you been deported, excluded (refused entry) or removed from any country? If you have answered yes to any of the above, please provide details Have you undertaken military service in any country? If yes, please provide a brief chronological account of your military service. Include dates of your military service, your position/rank, unit(s) that you served in, and your role within the unit(s). List any military ID number(s) assigned to you: Date from Date to Rank Unit Role Are you presently subject to military service obligations in any country? If yes please specify: If no and you are a citizen of a country in which compulsory military service exists, state why you are exempt from military service: Have you been associated with any intelligence agency or group, or law enforcement agency? If yes please specify: Have you been associated with any group or organisation that has engaged in or promoted the use of violence to further their aims. If yes please specify: Have you ever committed or been involved in the commission of war crimes, crimes against humanity, and/or human rights abuses? If yes please specify: 5
SECTION D: Immigration New Zealand Declaration - All applicants read and sign this declaration I have provided true and correct answers to the questions in this form. I agree to tell Immigration New Zealand about any changes to my circumstances that occur after making this application. I agree to leave New Zealand before my visa expires. If I remain in New Zealand after my visa has expired, I may be liable for deportation. I agree that if I am not entitled to free health care in New Zealand, I will pay for any health care or medical assistance I may require in New Zealand. I understand that Immigration New Zealand may provide information about my entitlement to work to potential employers via the online VisaView system. VisaView is authorised by legislation. I authorise Immigration New Zealand to provide information about my health and my immigration status to any health service agency. I authorise any health service agency to provide information about my health to Immigration New Zealand. I authorise Immigration New Zealand to make any necessary enquiries about information on this form so that they can: make a decision on this application answer enquiries about my immigration status once my application has been decided. I authorise any agency that holds information (including personal information) related to those matters to disclose that information to Immigration New Zealand. I authorise Immigration New Zealand to provide information about my immigration status to my past, present or future education provider and to the International Education Appeal Authority. If I am granted a student visa with the condition that I am accompanied by a legal guardian, I agree to live with my legal guardian. I understand that my visa and the visa of my legal guardian may be withdrawn if I do not meet this condition. If I am granted a limited visa, I agree that I will leave New Zealand on or before the expiry date of that visa. If I do not leave New Zealand, I may be immediately deported from New Zealand without the right of appeal. I authorise The University of Waikato to contact Immigration New Zealand regarding information on my visa status during the duration of my study at The University of Waikato. I authorise Immigration New Zealand to release relevant immigration status information to The University of Waikato. If I am granted a student visa with the condition that I hold acceptable insurance, I understand the requirements regarding insurance that I have agreed to on page 4. Signature of applicant Date Note: We cannot process your application until you have paid the visa fee and you are fully enrolled. The University of Waikato is not responsible for student visas expiring due to delays in paying the $195 application fee or the student not completing enrolment procedures. You cannot travel outside New Zealand before your visa label is issued by Immigration New Zealand. Academic Progress When you apply to renew your student visa, your academic progress is reviewed. It is a condition of your student visa that you must have 100% attendance, and pass at least 75% of your attempted papers. If you have not met these conditions the University may not be able to process you visa application and you would need to apply directly to Immigration New Zealand. Provisional Enrolment: Please note that once your visa application is accepted for processing you are only provisionally enrolled while we await the decision from INZ. If your application is declined, your enrolment will be cancelled. 6