JAN. 16.] THE NEW ZEALAND GAZETTE. 83

(12) (a) Reasons for desiring to settle in New Zealand :
(b) Business or occupation proposed to be undertaken in New Zealand :

(13) (a) Condition of mental and physical health of myself :
[To be supported by a certificate from a qualified medical practitioner.]
(b) Condition of mental and physical health of my wife and/or child(ren) :
[To be supported by a certificate from a qualified medical practitioner only if wife and/or child(ren) are to accompany applicant.]

(14) Amount of money (in English currency) which I undertake to bring to New Zealand :
(15) Language(s) in which I am able to read and write fluently:
(16) Intended place of future permanent residence in New Zealand (if known) :
(17) Full name[s] and address(es) of any relative[s] or friend(s) in New Zealand:

Full Name. Address. If Relative, state Nature
of Relationship; if Friend, state so.

(18) I am a person of good character and reputation. I have never been in prison or in a mental hospital or been the recipient of charitable aid. I am not a disaffected or dangerous person or one who advocates the overthrow by force or violence of constitutional government.
[To be supported by a certificate from a police officer or other public official.]
I forward herewith two unretouched and unmounted half-length recent photographs of a size not exceeding 4½ in. by 3½ in., and not less than 3 in. by 2 in., of myself [and of my wife and/or child(ren) if to accompany me]. These photographs were taken in the year 19

[Strike out words in brackets not required.]
Signature of applicant:
Dated at , this day of , 19
No. .
New Zealand Customs.
[Form 6.
PERMIT TO ENTER NEW ZEALAND.
(Under the Immigration Restriction Amendment Act, 1920.)
PERMISSION is hereby granted to , of , to enter New Zealand, accompanied by , [Strike out the words "accompanied by" if not required], on the following conditions :—
[Strike out any words not required.]

(1) That this permit will not entitle the person or persons named herein to enter New Zealand after the expiry of two years from the date hereof.
(2) That this permit will be delivered up to the Collector of Customs at the first port of arrival in New Zealand.
(3) That he [she] satisfies the Collector of Customs at the port of arrival that the particulars inserted hereunder concerning himself [herself] are correct.
(a) Full name:
(b) Sex:
(c) Nationality:
(d) Place and date of birth:
(e) Last place of permanent residence:
(f) Marital state:
(g) (i) Reasons for desiring to settle in New Zealand:
(ii) Occupation or business to be undertaken in New Zealand:
(h) That the condition of mental and physical health of himself [herself] is , and that the condition of mental and physical health of the persons mentioned above accompanying him [her] is:
(i) The amount of money in English currency which is brought by him [her] to New Zealand is not less than :

(j) That he [she] is able to read and write fluently in the following language(s), namely:—
(k) That he [she] is a person of good character and reputation, that he [she] has never been in prison or in a mental hospital or the recipient of charitable aid, and that he [she] is not a disaffected or dangerous person or one who advocates the overthrow by force or violence of constitutional government.
[Photograph of the person to whom this permit is granted.]
Dated at Wellington, New Zealand, this day of , 19 .
Comptroller of Customs.
*[The following declaration is to be made at the port of arrival in New Zealand by the person to whom this permit is granted.]

• I, , do hereby declare that the foregoing particulars concerning myself [and the person(s) named herein accompanying me] are true and correctly stated in every respect.
  Signature : Declared before me at , this day of , 19 .
  Officer of Customs.
  [Form 7.
  New Zealand Customs.
  APPLICATION FOR A PERMIT TO ENTER NEW ZEALAND AS A STUDENT.
  (Immigration Restriction Amendment Act, 1920.)
  [To be filled up in the English Language.]
  To the Honourable the Minister of Customs,
  Wellington, New Zealand.

I [Full name of intending student or of his father], of do hereby make application that a permit to enter New Zealand as a student for a period of [State length of period] be granted to me [or name of person to whom it is desired that permit should be granted] (hereinafter referred to as "the student"). I enclose a certificate in the prescribed form issued by the Consul for [Country of the student's nationality], and submit the following particulars respecting myself [the student].
[NOTE.—The reference to the Consular certificate to be struck out in the case of a British subject.]
(1) Full name:
(2) Sex:
(3) Present address:
(4) Nationality:
(5) Race or people to which student belongs:
(6) (a) Full names, places of birth, nationality, and full present addresses of parents—
(i) Father:
(ii) Mother:
(b) Country of domicile of father:
(c) Place and date of birth of student:
[To be supported by a statutory declaration by the father of the student as to their relationship, and a birth certificate or other evidence to the satisfaction of the Minister as to such relationship and the age and identity of the student.]
(7) (a) Whether previously in New Zealand:
(b) If so, when:
(8) Marital state:
(9) (a) Intended date of arrival in New Zealand:
(b) Intended place of residence in New Zealand:
[Exact address required.]
(10) (a) School, college, or University to be attended:
(b) Subjects to be studied:
(c) Whether intending to devote whole time to study:
(d) Whether will do any work in New Zealand, other than study:
If so, of what nature:
(11) Whether authorities of school, college, or University are willing to accept him as student:
[NOTE.—If so, letter or other communication from headmaster or principal to be forwarded as evidence with application.]
(12) Subjects which have been already studied, and standard of education reached in each: