Migrant Programme

Registration Form

The Ministry of Social Development is interested in collecting information about the people who enter the Migrant Business Start-up. Christchurch Small Business Enterprise Centre would therefore appreciate if you would answer the questions below and hand this registration form to the staff of Christchurch Small Business Enterprise Centre. We may ask the people who are providing the Programme to contact you later to ask you about the overall usefulness of the whole programme as well as collecting information for the Ministry of Social Development. Christchurch Small Business Enterprise Centre may also use the information you provide for our own statistical use. Furthermore, we send you newsletter and otherwise keep you informed of our services. Pursuant to the Privacy Act 1993, unless your permission is granted, no identifying information will be given to any party except staff contracted by the Christchurch Small Business Enterprise Centre to provide specific business advice or government departments or agencies who have referred you to this Centre or as may be specifically required or allowed by law. You have the right to access any information we may hold on you and to request that information to be updated or corrected. This information is stored at our offices located at Level 3, 141 Hereford Street, Christchurch. DECLARATION: I acknowledge that the Christchurch Small Business Enterprise Centre representative is providing me with advice in good faith and using professional judgement based on the information available to them at this time. I acknowledge that I will have no recourse against the Christchurch Small Business Enterprise Centre if that advice proves faulty or incorrect. All information I supply will be confidential, to the advisor confided in, and not be released without my permission.

1. First Name:_BABY JOY LULETTE_______

Family/Last Name:_PAGADUAN__________

2. Preferred Name if any:__JOY________________ 3. Residential Address:_1/6 DIVISION ST.,RICCARTON, CHRISTCHURCH_______________ 4. E-mail Address:_pagaduan_joy@yahoo.com__________________________________________ 5. Telephone (Home/Office):_(03) 550-1590________Mobile:__021 0380873_________________ 6. Permanent Resident: Category of Approval (please underline the correct one) Skilled Migrant, Work to residence, Partnership, Parent, Entrepreneur, Investor or others 7. Date: First Arrival in New Zealand _14 NOV 2011_____________________ 8 Date: Starting Date of Permanent Residency__10 OCT 2011_____________

9. How did you hear about our Small Business Enterprise Centre?

I read about it on the free Community News Paper ___________________

10. What level is your highest educational Qualification?

Bachelors Degree ______________________________________________________________

Please submit with copy of your passport - (Photo page & Visa page)

Signature:

Date___12 FEB 2013___________________