Complete Assessment

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your currently

SECTION A: PERSONAL DETAILS

Name (as it appears on your passport) *

First

Last

Date of Birth

City and Country of Birth

Country(ies) of Citizenship (list all)

Please indicate all languages you are able to communicate in (select box):

English
French
Native Language / Mother Tongue

List languages below

SECTION B: CONTACT DETAILS

Provide your current residential address (this is the address where you physically live):

Provide your current mailing address (if different from your residential address):

Email Address: *

Home Number:

Cell Number:

Work Number:

SECTION C: ADMISSIBILITY

Important Instructions: Review these questions with EXTREME care.

Do any of the following questions apply to you:

a) Within the past two years, have you or a family member ever had tuberculosis of the lungs or been in contact with a person with tuberculosis?

b) Do you have any physical or mental disorder that would require social and/or health services, other than medication, during a stay in Canada?

c) Have you ever remained beyond the validity of your status, attended school without authorization or worked without authorization in Canada? Keep in mind that if you ever had to restore your status in Canada, then the answer to this question would be “yes”.

d) Have you ever applied for OR been refused refugee status in ANY country?

e) Have you ever applied for OR been refused a permanent resident visa in ANY country?

f) Have you ever applied for OR been refused a visitor or temporary resident visa in ANY country?

g) Have you ever applied for OR been refused a work permit in ANY country?

h) Have you ever applied for OR been refused a study permit in ANY country?

i) Have you ever applied for OR been refused for ANY other type of visa, permit, etc. than those listed above, in ANY country?

j) Have you ever been refused admission to (i.e. stopped at the border and not allowed to enter), or ordered to leave, Canada or ANY other country?

k) Have you EVER applied to enter or remain in Canada? Applied could mean applying for a visa OR if you are visa-exempt it could mean arriving at a border (land or airport) and not being allowed to enter the country.

l) Have you ever committed, been arrested for, been charged with or convicted of any criminal offence in any country?

m) Did you ever serve in any military, militia, or civil defense unit or serve in a security organization or police force (including non-obligatory national service, reserve or volunteer units?

n) Are you, or have you ever been, a member or associated with any political party, or other group or organization which has engaged in or advocated violence as a means to achieving a political or religious objective, or which has been associated with criminal activity at any time?

o) Have you ever witnessed or participated in the ill treatment of prisoners or civilians, looting or desecration of religious buildings?

If you answered yes to any of the questions above, please provide details:

SECTION D: TRAVEL HISTORY

1. If you are NOT currently in your home country and living outside of your country of citizenship, please provide the following details:

In what country are you currently living

Purpose of visit:

Date of Entry:

Date when your status expires/you must leave the country:

2. In the past 10 years, have you lived in any country for 6 months or longer, except for your country of citizenship?

Country Visited:

Your status (include countries that you entered illegally):

Purpose of visit:

Date of Entry:

Add

Add Country?

Date of Exit:

Country Visited:

Your status (include countries that you entered illegally):

Purpose of visit:

Date of Entry:

Add

Add Country?

Date of Exit:

Country Visited:

Your status (include countries that you entered illegally):

Purpose of visit:

Date of Entry:

Date of Exit:

SECTION E : PROFESSIONAL DETAILS

PERSONAL HISTORY CHART (last 10 years):

From

Work / Business description

(what were you doing in this period. If employed, state your job title)

Location

(City / Country)

Status in Country

Employer or Institution Name

Add more employment?

From

Work / Business description

(what were you doing in this period. If employed, state your job title)

Location

(City / Country)

Status in Country

Employer or Institution Name

Add more employment?

From

Work / Business description

(what were you doing in this period. If employed, state your job title)

Location

(City / Country)

Status in Country

Employer or Institution Name

SECTION F: EDUCATION DETAILS

1. Do you have any post-secondary education? Post-secondary education is schooling obtained after grade 12.

If you answer yes, please provide details of your highest level of post- secondary education in the chart below. If you attended more than one institution to obtain your diploma/degree/etc., please provide information for all institutions.

Institution/School Name:

From

Field of Study (ex. Administration, Chemical Engineering, etc.):

City/Country:

Level:

Type of Certificate or Degree/Diploma received (ex. Bachelor’s Degree, etc.):

Institution/School Name:

From

Field of Study (ex. Administration, Chemical Engineering, etc.):

City/Country:

Level:

Type of Certificate or Degree/Diploma received (ex. Bachelor’s Degree, etc.):

SECTION G: GOVERNMENT & MILITARY DETAILS

1. Have you ever held any government position, regardless of whether it was a paid position or not?

Important Instructions: - This includes any of the following: civil servant, judge, police officer, employee in a security organization - This includes all levels of government (municipal, regional, national)

2. Have you ever been involved in the military or paramilitary in any country?

Important Instructions: - This includes: If you actively served in the military or were a member of the reserves or never actively served, and/or never received training, but were registered as a “member” of the military in any country

SECTION H: MARITAL AND CHILDREN DETAILS

Are you married?

If you are married will your spouse apply to Canada?

Do you have any children?

Paragraph Text

Please write how many children you have and their age.

If you have children, will they apply to Canada?

SECTION I : LANGUAGE TEST

Have you taken a test on Academic / General IELTS?

Type

Academic
General

Writing

Reading

Listening

Speaking

Please mention the result publishing date

(DD-MM-YYYY)

SECTION J : PROOF OF FUND

How much money do you have in your possession which is liquifiable? Means, the money you have in the bank. Your property, car, gold, invested in business / share market etc. does not count.

Please mention the amount in CAD$. To convert the rate, please take the rate from the central bank of your country.

SECTION K : FIRST BLOOD RELATIVE IN CANADA

Do you or your spouse (if married) have any first blood relative living in Canada?

The relationship between you and the relative living in Canada.

Their current address (City and Province only) of Canada

The date they started staying in the above address

Their residency status (PR / Citizen / Student / Worker)

Please list your TOP 5 questions for the consultation:

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Start Your Journey To Canada Today

Complete An Assessment

SECTION A: PERSONAL DETAILS

SECTION B: CONTACT DETAILS

SECTION C: ADMISSIBILITY

Do any of the following questions apply to you:

SECTION D: TRAVEL HISTORY

1. If you are NOT currently in your home country and living outside of your country of citizenship, please provide the following details:

SECTION E : PROFESSIONAL DETAILS

SECTION F: EDUCATION DETAILS

SECTION G: GOVERNMENT & MILITARY DETAILS

SECTION H: MARITAL AND CHILDREN DETAILS

SECTION I : LANGUAGE TEST

SECTION J : PROOF OF FUND

SECTION K : FIRST BLOOD RELATIVE IN CANADA