Immigration & Visa Assessment Form

    Fields marked with an * are required
    Your Personal Profile

    Your Name* :

    Age* :

    Marital Status* :

    Is your spouse travelling with you?

    Do you have any children under 19 going with you?

    Nationality* :

    Which nation is your primary citizenship?*

    Which country are you currently living in?*

    Have you ever been charged with a criminal offence?*

    Please briefly describe the nature of the offense and when it occurred :

    What is the purpose of your inquiry?

    Please summarize your work history, including job title, main duties and date within the last 10 years or provide your Resume:

    Education* :

    How many years of formal education? (This includes: Elementary/primary school - Secondary/high school - University/college - Trade school or other post secondary school)*

    Language Ability :

    If your English/French reaches intermediate or advanced level, have you ever taken language exam(s) such as IELTS OR CELPIP/TEF (Canada) OR TCF (Canada). If yes, please list the date(s) and result of the exam(s):

    Do you have a job offer from a Canadian employer?

    Occupation Title being offered to work in Canada if you have a job offer:

    If you are studying or going to study in Canada, provide the Name of School or Institution in Canada:

    Current Enrollment Status* :

    Please enter any other relevant details about your program of study in Canada:

    Do you have any relatives in Canada?

    What is your relationship to your relative(s)?

    Have you ever applied for a visa to Canada before?

    Please explain about your previous visa application (s), including any refusal(s) and travel history:

    Please indicate the total value of your assets in US Dollars (including, cash, real estate, investments, business, etc.) under you and/or your spouse's name * :

    Questions or Comments

    Please add any questions, extra info that is relevant to your inquiry, such as program(s) you are interested in and info about your spouse's highest education, language ability and study or work experience in Canada if applicable :

    First Name* :

    Last Name* :

    Email* :

    Confirm Email* :

    Phone Number* :

    Alternative Phone Number:

    What is the best way to contact you?

    Other Alternative:

    When would you like our assistance?

    What is the ideal time to contact you?

    All times are in EST (Eastern Standard Time), or UTC-05:00 :

    What help do you want?

    Reference

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