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Silver Fern Questionnaire5.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/ContactDetails/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=innercontainer><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="newtabbutton" 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=current><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="newtabbuttonon" 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>Contact 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 width="35%">
Email Address
<br />
Note: This is the email address that will be used to contact you about this application. Please note, if you have an immigration adviser acting on your behalf, a copy of the emails sent to you will also be sent to them.
</td>
<td width="5%">
</td>
<td width="35%" nowrap="nowrap">
<input id="EmailAddress_Value" maxlength="100" name="EmailAddress.Value" type="text" value="[email protected]" />
<span style="font-family: 'Arial', Times, serif; font-size: large; color: #800000">*</span>
</td>
<td>
<span class="SilverFernErrorMessage"></span>
</td>
<td>
</td>
</tr>
<tr>
<td width="35%">
Confirm email address
</td>
<td width="5%">
</td>
<td width="35%" nowrap="nowrap">
<input id="EmailAddressConfirm_Value" maxlength="100" name="EmailAddressConfirm.Value" type="text" value="" />
<span style="font-family: 'Arial', Times, serif; font-size: large; color: #800000">*</span>
</td>
<td>
<span class="SilverFernErrorMessage" style= "visibility: hidden;">You must answer this question.</span>
</td>
<td>
</td>
</tr>
</tbody>
</table>
<table width="100%">
<tbody>
<tr>
<td width="35%">
<!--SR238851_0963_Global Changes - Req22 - Just a typo error Change - KarthicK - 19072010 -->
Are you represented by an <a href="http://glossary.immigration.govt.nz/immigrationadviser" id="ImmigrationAdvisersLink" target="_blank" title="Link opens in a new window" onclick="window.open('http://glossary.immigration.govt.nz/immigrationadviser','newpopuppopup','toolbar=no ,menubar=no ,location=no ,status=yes ,directories=no ,scrollbars= yes ,resizable= yes ,width=600 ,height=434'); return false" >immigration adviser</a>?
</td>
<td width="5%">
</td>
<td width="35%" nowrap="nowrap">
<select id="HasAgent_Value" name="HasAgent.Value"><option value="">Select an option</option>
<option value="Yes">Yes</option>
<option value="No">No</option>
</select>
<span style="font-family: 'Arial', Times, serif; font-size: large; color: #800000">*</span>
</td>
<td>
<span class="SilverFernErrorMessage" style= "visibility: hidden;">You must answer this question.</span>
</td>
</tr>
</tbody>
</table>
<h3>
Current Residential Address:</h3>
<table width="100%">
<tbody>
<tr>
<td width="35%">
Street Number
</td>
<td width="5%">
</td>
<td width="35%" nowrap="nowrap">
<input id="StreetNumber_Value" maxlength="8" name="StreetNumber.Value" type="text" value="" />
</td>
<td>
<span class="SilverFernErrorMessage"></span>
</td>
</tr>
<tr>
<td width="35%">
Street Name
</td>
<td width="5%">
</td>
<td width="35%" nowrap="nowrap">
<input id="Address1_Value" maxlength="100" name="Address1.Value" type="text" value="" />
<span style="font-family: 'Arial', Times, serif; font-size: large; color: #800000">*</span>
</td>
<td>
<span class="SilverFernErrorMessage" style= "visibility: hidden;">You must answer this question.</span>
</td>
</tr>
<tr>
<td width="35%">
Suburb
</td>
<td width="5%">
</td>
<td width="35%" nowrap="nowrap">
<input id="Suburb_Value" maxlength="100" name="Suburb.Value" type="text" value="" />
</td>
<td>
<span class="SilverFernErrorMessage"></span>
</td>
</tr>
<tr>
<td width="35%">
City
</td>
<td width="5%">
</td>
<td width="35%" nowrap="nowrap">
<input id="City_Value" maxlength="100" name="City.Value" type="text" value="" />
<span style="font-family: 'Arial', Times, serif; font-size: large; color: #800000">*</span>
</td>
<td>
<span class="SilverFernErrorMessage" style= "visibility: hidden;">You must answer this question.</span>
</td>
</tr>
<tr>
<td width="35%">
Province/State
</td>
<td width="5%">
</td>
<td width="35%" nowrap="nowrap">
<input id="Province_Value" maxlength="30" name="Province.Value" type="text" value="" />
</td>
<td>
<span class="SilverFernErrorMessage"></span>
</td>
</tr>
<tr>
<td width="35%">
PIN/ZIP code
</td>
<td width="5%">
</td>
<td width="35%" nowrap="nowrap">
<input id="PostCode_Value" maxlength="15" name="PostCode.Value" type="text" value="" />
</td>
<td>
<span class="SilverFernErrorMessage"></span>
</td>
</tr>
<tr>
<td width="35%">
Country
<br />
Note: You must be outside New Zealand to apply for a Silver Fern Job Search visa.
</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="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" style= "visibility: hidden;">You must answer this question.</span>
</td>
</tr>
</tbody>
</table>
<table width="100%">
<tr>
<td colspn = "4">Please provide the telephone numbers at which you can be contacted:</td>
</tr>
<tr>
<td width="35%">Phone (daytime)</td>
<td width="5%">
</td>
<td width="35%" nowrap="nowrap">
<input id="DayPhoneNumber_Value" maxlength="25" name="DayPhoneNumber.Value" type="text" value="" />
</td>
<td>
<span class="SilverFernErrorMessage"></span>
</td>
<td></td>
</tr>
<tr>
<td></td>
<td></td>
<td colspan="2" class="smalltext">(CountryCode AreaCode TelephoneNumber e.g. 64 4
1234567)</td>
</tr>
<tr>
<td width="35%">Phone (night)</td>
<td width="5%">
</td>
<td width="35%" nowrap="nowrap">
<input id="NightPhoneNumber_Value" maxlength="25" name="NightPhoneNumber.Value" type="text" value="" />
</td>
<td>
<span class="SilverFernErrorMessage"></span>
</td>
<td></td>
</tr>
<tr>
<td></td>
<td></td>
<td colspan="2" class="smalltext">(CountryCode AreaCode TelephoneNumber e.g. 64 4
1234567)</td>
</tr>
<tr>
<td width="35%">Phone (mobile)</td>
<td width="5%">
</td>
<td width="35%" nowrap="nowrap">
<input id="CellPhoneNumber_Value" maxlength="25" name="CellPhoneNumber.Value" type="text" value="" />
</td>
<td>
<span class="SilverFernErrorMessage"></span>
</td>
<td></td>
</tr>
<tr>
<td></td>
<td></td>
<td colspan="2" class="smalltext">(CountryCode NetworkCode TelephoneNumber e.g. 64
21 1234567)</td>
</tr>
<tr>
<td width="35%">Fax</td>
<td width="5%">
</td>
<td width="35%" nowrap="nowrap">
<input id="FacsimileNumber_Value" maxlength="25" name="FacsimileNumber.Value" type="text" value="" />
</td>
<td>
<span class="SilverFernErrorMessage"></span>
</td>
<td></td>
</tr>
<tr>
<td></td>
<td></td>
<td colspan="2" class="smalltext">(CountryCode NetworkCode TelephoneNumber e.g. 64
21 1234567)</td>
</tr>
</table>
</td>
<td width="20">
</td>
</tr>
<tr>
<td colspan="4">
</td>
</tr>
</tbody>
</table>
</div>
<span class="errormessage">
<p>
<b>Important – please check the information you have entered carefully to ensure it is correct before going to the next section.</b>
</p>
</span>
<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>
</form>
</div>
</div>
</td>
</tr>
<tr valign="bottom">
<td><!-- just show this copyright text where needed -->
<p class="footer">© 2010 Immigration New Zealand. All rights reserved.
Version
<span id="ctl00_FooterUC2_versionLabel">1.0.20.0</span>.</p>
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