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Assessment Questionnaire
 
Surname * First Name * Middle Name *  
 
Gender Date of Birth (DD/MM/YYYY)
Place of Birth * Citizenship *    
Current Mailing Address: *        
Tel No.: Off:* Resi* Mobile*
E-mail Address *    
Your Country of Preference      
Present Marital Status      
Detail of Spouse & Children        
Last Name First Name Citizenship Date of Birth Marital Status Relationship  
 
 
 
 
Detail of Eductaion Qualification since Matriculation : (Full Time/Part Time)
From Year To Year Univ./Board Regular/
Correspondence
Degree Division %age
Please Indicate your Capability to communicate in english language :
Speak          
Read          
Write          
Listen          
Detail of Work History for last 20 years :
From Date To Date Name & Address of Employer Designation  
 
 
 
Detailed description of Job Responsibilities performed since you started working :
Present Designation Current Gross Monthly Earnings  Intended Occupation  
Name and Address of Relatives in New Zealand / Canada / Australia / UK / USA and their relationship :
Name & address  Country Relation  
 
 
 
Details of assets :          
Transferable Money Property & Fixed Assets  Bank Balance & Liquid Assets 
Detail of Highest Education Completed by Spouse :
Spouse Work History for last 20 years :      
From Date To Date Name & Address of Employer Designation  
 
 
 
Have you studied in NEW ZEALAND/CANADA/AUSTRALIA/UK/USA for 2 years :
Have you worked full time in NEW ZEALAND/CANADA/AUSTRALIA/UK/USA for 1 years :
Do you have a job offer, Informal/Certified from NEW ZEALAND/CANADA/AUSTRALIA/UK/USA :
Have you ever applied for immigration :
How did you know about Diamond Groups: *
             
           
             
 
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