Apply - Application for Work From Bermuda One Year Residential Certificate

This application is for people who are currently employed and working from home or enrolled in tertiary education and studying remotely. Instead of working or studying remotely in your home country, you can work or study remotely from Bermuda. While working or studying remotely in Bermuda with this certificate, you will not be allowed to seek work with a local company.

This form will take about 15 minutes to complete if you have all the information immediately available. The application fee is $263 and is non-refundable. Your payment must be received by the Government of Bermuda in order for the application to be processed. The form must be completed in English.

You need the following to complete this form:

proof of employment or evidence of school enrolment;
color scan of your passport photo page;
color scan of visa information;
all supporting documentation should also be in English, where practical

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Submission Date
Month - Day - Year
Personal Details
First Name
Middle Name
Last Name
Do you have any previous names?
Previous Names
Are you a student?
Nationality at Birth
Date of Birth
Month - Day - Year
Present Nationality
Country of Birth
Home Phone
Work Phone
Cell Phone
Email
Do you have family resident in Bermuda?

Current Address

Street Address
Street Address 2
City	Region
Postal Code	Country

Legal Address Outside of Bermuda

Street Address
Street Address 2
City	Region
Postal Code	Country

Have you ever been convicted in a court of law on any criminal or civil proceedings?
How many convictions
Nature of Offence (1)
Date of Offence (1)
Month - Day - Year
Country of Offence (1)
Sentence (1)
Nature of Offence (2)
Date of Offence (2)
Month - Day - Year
Country of Offence (2)
Sentence (2)
Employer or School Information
Employer or School Name
Employer or School Phone
Job Title or Degree Program

Employer or School Address

Street Address
Street Address 2
City	Region
Postal Code	Country

Please upload proof of employment or school enrolment (letter from employer, school acceptance letter etc.)
Filename
Size
Process
Status
Add Files
Travel Information
Passport number
Place of issue
Passport date of issue
Month - Day - Year
Passport date of expiry
Month - Day - Year
Please upload a scanned COLOR copy of your passports photo page
Filename
Size
Process
Status
Add Files
Date of arrival in Bermuda
Month - Day - Year
1-Year residential start date (Must be less than 9 months from today)
Month - Day - Year
Are there any restrictions to your right to return to your country of origin?
If yes, provide explanation
Visa (Note: Expiration dates must meet the requirements of the visa policy for Visa Controlled Nationals.)
Legal residents of the US, Canada, UK or the EU do not require a visa to enter Bermuda..
Where applicable are your visas in order?
Visa date of issue
Month - Day - Year
Visa date of expiry
Month - Day - Year
Please upload a scanned COLOR copy of your visa information
Filename
Size
Process
Status
Add Files
Save & Resume Later

Financial Support
Your health insurance provider
Health insurance policy number
Will you be financially self-supporting?
How do you intend to support yourself while in Bermuda?
Your current approximate annual income
Will you be financially supported by a sponsor?
Sponsor First Name
Sponsor Last Name
Your relationship to sponsor
Sponsor’s current approximate annual income
Emergency Contact Information: Outside of Bermuda
Emergency Contact First Name
Emergency Contact Last Name

Address Overseas

Street Address
Street Address 2
City	Region
Postal Code	Country

Emergency Contact Home Phone
Emergency Contact Work Phone
Emergency Contact Cell Phone
Emergency Contact Email
Save & Resume Later

Sponsored Dependents
Do you have sponsored dependents?
Please list the applicant names
Disclaimers
Click here to view/download the terms of use.
I have read and accept the Terms of Use
I understand that under the provisions of the Bermuda Immigration and Protection Act, 1956, it is a criminal offence to make any statement which is false in a material particular and which I know to be false or I believe not to be true. I understand that breach of the Bermuda Immigration and Protection Act, 1956 may cause my permission to reside in Bermuda to be revoked. I understand am not regarded as an immigrant and there is no guarantee to continue residence in Bermuda at any time.
I Understand the above statement and all information submitted is accurate
I confirm that I have read this form and I understand and consent to you collecting and sharing my personal information with your partners, including but not limited to, Bermuda Development Agency and the Bermuda Tourism Authority, for the purpose of marketing, communication, advertising and processing my personal information. This consent is also considered as the consent to send me electronic mail messages.
Payment Information
Length of stay requested
Total Amount
Total Cost: ${showTotal}

Offline for system maintenance

Personal Details

Employer or School Information

Travel Information

Financial Support

Emergency Contact Information: Outside of Bermuda

Sponsored Dependents

Disclaimers

Payment Information

Total Cost: ${showTotal}