Given Names (from pas)

	Questions	Answers
1	Given Names (from pas)	NODIRBEK
2	Surname (from pas)	URINBAEV
3	Other names	ERKINOVICH
4	If you changed family name, so write you other family names and reason for changing
5	Mobile Telephone (for example [phone])	[phone]
6	e-mail  Please check your email every day	[e-mail]
7	Do you hold any other nationalities?	Yes No✓ if yes, so write which one
8	Date of birth (00/02/1111)	18/04/1989
9	Does any direct relatives travel with you (father, mother, wife, children)? Write last name and first name in English and who this person is for you	No
10	Current passport or travel document number (in the format FK747744)	FA0522699
11	Date of issue (day/month/year)	03/08/2019
12	Date of expiry (day/month/year)	02/08/2029
13	Issuing authority	MIA 3000
14	Place of issue of passport	Andijan IIB
15	Is this your first passport?	Yes✓ No If no, write travel documents number and send the copy of that
16	What is your marital status?	Married single✓ If you married, send copy of your marriage Certificate
17	Do you have any children	Yes No✓ If yes, write name and surname and date of birth
18	Place of birth (for example Lviv)	Andijan
19	Country of birth	Uzbekistan
20	Do you have directly relatives in Great Britain?	Yes No✓ If yes -who is it? How many? Their address and do you plan to visit them?
21	Your address in Uzbekistan	Apt/Floor/Suite/Room/Street 2A, Yorqin street, Bagishamal City/Town/Village Andijan Region Andijan Country Uzbekistan Post code 171100
22	How long have you lived at this address? (how many years)	32 years
23	Name, surname and tel number of person, which we can contact if something happened (For example Pavlo Melnyk [phone])  and all your mobile numbers (for example [phone])	URINABEVA ZULKHUMOR [phone]
24	Your immigration history Have you been granted a UK visa?	Yes No✓
25	Have you ever travelled to the UK?	Yes No✓ If so, indicate the type of visa, date, duration, and purpose of stay. Which airport / border crossing point? Land, air transport?
26	Have you been or worked illegally in the UK?	Yes No✓
27	Have you ever been deported‚ removed or otherwise required to leave the UK?	Yes No✓
28	Do you have any others UK visa applications valid at the moment? Are there any appeals against the refusal of a visa to the UK?	Yes No✓
29	Have you ever been refused a visa for the UK?	Yes No✓
30	Have you been refused entry on arrival to the UK ?	Yes No✓
31	Have you made an application to the Home Office to remain in the UK in the last 10 years?	Yes No✓
32	Have you ever travelled outside your country or residence‚ in the last 10 years?	Yes No✔
33	Have you ever been refused a visa for any country?	Yes No✓ If yes, write the reason
34	Have you ever been deported‚ removed or otherwise required to leave another country?	Yes No✓ If yes, write which country and reason
35	Do you have any criminal convictions in any country (including traffic offences)?	Yes No✓
36	Information about your family Will any other children be travelling with you?	Yes No✓
37	Name and surname (in English) of your spouse, your children, their passport data, date of birth, nationality	No
38	Father's given name	DIVORCED
39	Father's family name	N/A
40	Father's date of birth	N/A
41	Father's place and country of birth (for example Lviv/Ukraine )	N/A
42	Father's nationality/nationalities.	N/A
43	Mother's given name	ZULKHUMOR
44	Mother's family name	URINBAEVA
45	Mother's date of birth	13/12/1958
46	Mother's place and country of birth (for example Lviv/Ukraine)	Andijan/Uzbekistan
47	Mother's nationality/nationalities	Uzbek
48	Additional Information Please provide detailed information on jobs, including any qualifications, be sure to indicate your experience in agriculture in Uzbekistan or abroad Do you have documented experience in driving specialized vehicles and passenger vehicles? If yes, indicate which one (tractor, combine, loader, minibus, bus, etc.) Yes No Others	Experience: 8 months practice in green house in oq oltin farm in 2021 picking soft fruits and vegetables ( strawberries and raspberries apples cherries etc.)
49	English language proficiency	1 – poor✓ 2 – satisfactory 3 – good 4 - very good 5 – excellent
50	Do you have health problems that may affect your ability to do work?	Yes No✓
51	Do you have any form of criminal record or affiliation with any terrorist organization?	Yes No✓
52	Do you understand that all work will be related to agriculture and will need to work outdoors and weather conditions can affect the duration of work ?	Yes✓ No
53	Reasons why you will return home after your stay in the UK?	Family, Home, Marriage
54	What kind of work are you interested in?	picking soft fruits (strawberries, raspberries, cherries, apples, pears, etc.)✓ collection of salads and vegetables collection and packaging of mushrooms
55	Please indicate when it is more convenient for you to start working in the UK	Asap (as soon as possible)✓ March April May June July August September October November December January February
56	Do you want to join us with family or friends? If so, please write their names in English (from the passport) AND THEIR PASSPORT NUMBER The questionnaires of these people should already be in the possession of a company representative (for example Melnyk Ivan FA323245; Rudyk Petro FJ987468)
57	E-mail Address
58	What kind of work do you have in the priority?	picking soft fruits (strawberries, raspberries, cherries, apples, pears, etc.)✓ collection of salads and vegetables collection and packaging of mushrooms
59	If you are considering other types of work, indicate this	picking soft fruits (strawberries, raspberries, cherries, apples, pears, etc.) collection of salads and vegetables✓ collection and packaging of mushrooms