New Zealand Residency

Registration Form No. PNG/06/03

Please fill in all the * required details. Do not fill this form in on behalf of anyone else.
Please PRINT your details clearly in the boxes provided.

Papua New Guineans with New Zealand Residency

* First Name			* Date of Entry into NZ
* Surname/Lastname			* Length of Stay in NZ
* Date of Birth			Name of Spouse (if any)
* Home Province/Village			Other Dependents (if any)
Contact Address in PNG			* Postal Address
E-Mail Address			Telephone Number in NZ

Please tick one of the following:

Yes I would like my details put on the list of “Papua New Guineans residing in New Zealand” to be available for fellow Papua New Guineans to view.

Please do not display or give out any of my details without my consent.

Signature

Current Date

Any Comments

If any of your information changes please notify the Papua New Guinea High Commission
post: 279 Willis Street, P.O Box 197 Wellington New Zealand
ph: 04 385 2474 fax: 04 385 2477 e: pngnz @ globe.net.nz