Assessment Form

Home Assessment Form

(if no further form cannot be required to open or stop)

[[[["field183","equal_to","Yes"]],[["show_fields","field185"]],"and"],[[["field187","equal_to","Yes"]],[["show_fields","field188"]],"and"],[[["field189","equal_to","Yes"]],[["show_fields","field190"]],"and"],[[["field191","equal_to","Yes"]],[["show_fields","field192"]],"and"],[[["field193","equal_to","Yes"]],[["show_fields","field194"]],"and"],[[["field196","equal_to","Yes"]],[["show_fields","field197"]],"and"],[[["field198","equal_to","Yes"]],[["show_fields","field199"]],"and"],[[["field200","equal_to","Yes"]],[["show_fields","field201"]],"and"],[[["field202","equal_to","Yes"]],[["show_fields","field203"]],"and"],[[["field204","equal_to","Yes"]],[["show_fields","field205"]],"and"],[[["field206","equal_to","Yes"]],[["show_fields","field207"]],"and"],[[["field209","equal_to","Yes"]],[["show_fields","field210"]],"and"],[[["field211","equal_to","Yes"]],[["show_fields","field212"]],"and"],[[["field213","equal_to","Yes"]],[["show_fields","field214"]],"and"],[[["field216","equal_to","Yes"]],[["show_fields","field217"]],"and"],[[["field218","equal_to","Yes"]],[["show_fields","field219"]],"and"],[[["field220","equal_to","Yes"]],[["show_fields","field221"]],"and"],[[["field224","equal_to","Yes"]],[["show_fields","field230"]],"and"],[[["field226","equal_to","Yes"]],[["show_fields","field231"]],"and"],[[["field234","equal_to","Yes"]],[["show_fields","field235"]],"and"],[[["field233","equal_to","Yes"]],[["show_fields","field236"]],"and"],[[["field237","equal_to","Yes"]],[["show_fields","field238"]],"and"],[[["field241","equal_to","Yes"]],[["show_fields","field242"]],"and"],[[["field244","equal_to","Yes"]],[["show_fields","field245"]],"and"],[[["field246","equal_to","Yes"]],[["show_fields","field247"]],"and"],[[["field250","equal_to","Yes"]],[["show_fields","field251"]],"and"]]
1 Step 1

Tell us How can We Help You?

Why do you want to go to Canada?

Who are you : Applicant or sponsor

Client Assessment Form

Last Name
First Name
Middle Name

Mailing Address

House No
Street
City
State
Country
Postal code

Telephone

Work
Business
Fax

Personal Information

Date of Birth
date_range
Sex

Place of Birth

City
State
Country

Citizenship

Marital Status:

Education Info

Period

Courses

From - To
Name & Address of Institutions
Degree / Diploma / Certificate Issued
From - To
Name & Address of Institutions
Degree / Diploma / Certificate Issued
From - To
Name & Address of Institutions
Degree / Diploma / Certificate Issued
From - To
Name & Address of Institutions
Degree / Diploma / Certificate Issued
From - To
Name & Address of Institutionsyour full name
Degree / Diploma / Certificate Issued
From - To
Name & Address of Institutions
Degree / Diploma / Certificate Issued
Total Years of school successfully completed
Years
Employment:
Intended Occupation In Canada

Work History

Date: From - toyour full name
Name & Address of Employer
City & Country
Job Designation
Date: From - To
Name & Address of Employer
City & Country
Job Designation
Date: From - to
Name & Address of Employer
City & Country
Job Designation
Date: From - to
Name & Address of Employer
City & Country
Job Designationyour full name
Date: From - toyour full name
Name & Address of Employer
City & Country
Job Designation
Date: From - to
Name & Address of Employer
City & Country
Job Designation

Present Occupation

Current Occupation
Current Monthly Earnings

Job Description

Please attach a separate Sheet giving a detailed description of the job responsibilities performed by you on a day to day basis:

Fileupload
cloud_uploadUpload

Total Work Experience:

How many Years of work experience do you have in the last 10 years?

Transferable Funds / Assets:

Cash (in Cdn$)
Property

Spouse Info: If you are married or engaged please provide details of spouse

Name
Date of Birth:
date_range
Citizenship
Occupation
Experience:
Date of Marriage
date_range
Place

Education

Highest Completed
University Degree
Non-University Diploma

Years of School:

How many years of school have you completed?
Total Years

Family Info

Children
Full Name
Date of Birth
date_range
Children
Full Name
Date of Birth
date_range

Indicate Relatives In Canada If Any

Name
Relationship
Address

Education Info

Period: From - To
Name & Address of Institutions
Courses
Degree / Diploma / Certificate Issued
Period: From - To
Name & Address of Institutions
Courses
Degree / Diploma / Certificate Issued
Period: From - To
Name & Address of Institutions
Courses
Degree / Diploma / Certificate Issued

Total Years of school successfully completed

Years
Employment
Intended Occupation In Canada

Work History

Date : From - To
Name & Address of Employer
City & Country
Job Designation
Date: From - To
Name & Address of Employer
City & Country
Job Designation
Date: From - To
Name & Address of Employer
City & Country
Job Designation

Present Occupation

Current Occupation
Current Monthly Earnings

Job Description:

Please attach a separate Sheet giving a detailed description of the job responsibilities performed by you on a day to day basis:

Fileupload
cloud_uploadUpload

Total Work Experience:

How many Years of work experience do you have in the last 10 years?

Transferable Funds / Assets:

Cash (in Cdn$)
Property
Other Details
Do you hold a Valid passport or travel document? Latest only
Document uploadupload
cloud_uploadUpload
Do you hold a college or university education?
college or university documentsupload
cloud_uploadUpload
Do you hold a work experience or employment?
experience or employment Documentsupload
cloud_uploadUpload
Do you hold transferable Funds or Assets?
transferable Funds or Assets documentupload
cloud_uploadUpload
Do you hold a work permit for Canada?
work permit for Canadaupload
cloud_uploadUpload
Do you hold a study permit for Canada?
study permit for Canada Documentupload
cloud_uploadUpload
Do you hold Temporary resident status for Canada?
Temporary resident status for Canadaupload
cloud_uploadUpload
Do you hold English language proficiency test certificate for Canada?
certificate for Canada Documentupload
cloud_uploadUpload
Do you hold French language proficiency test certificate for Canada?
Do you hold French language proficiency test certificate documentupload
cloud_uploadUpload
Do you have a job offer or potential job offer from a Canadian employer?
Do you have a job offer or potential job offer from a Canadian employer documentupload
cloud_uploadUpload
Have you or your spouse, common law partner or same sex partner ever worked in Canada for one full year?
Have you or your spouse, common law partner or same sex partner ever worked in Canada for one full year documentupload
cloud_uploadUpload
Have you or your spouse, common law partner or same sex partner ever studied in Canada for more than two years?
Have you or your spouse, common law partner or same sex partner ever studied in Canada for more than two years Documentupload
cloud_uploadUpload
Do you or your spouse, common law partner or same sex partner have a valid offer of employment in Canada upon your arrival?
Do you or your spouse, common law partner or same sex partner have a valid offer of employment in Canada upon your arrival Documentupload
cloud_uploadUpload
Do you have a spouse, common law partner or same sex partner who is a Canadian Citizen or Permanent Resident?
Do you have a spouse, common law partner or same sex partner who is a Canadian Citizen or Permanent Resident documentupload
cloud_uploadUpload
Do you or your spouse, common law partner or same sex partner have any close family relationships in Canada?
Do you or your spouse, common law partner or same sex partner have any close family relationships in Canada Documentupload
cloud_uploadUpload
Will you be able to bring with you more than Cdn $25000 when you immigrate?
Will you be able to bring with you more than Cdn $25000 when you immigrate Documentupload
cloud_uploadUpload
Do you applied for Canadian study visa? Mention If refused provide refusal letter
Do you applied for Canadian study visa? Mention If refused provide refusal letter Documentupload
cloud_uploadUpload
How did you come to know about our Immigration Consultancy firm?

Background Information

You must complete this section if you are 18 years of age or older.

1)

a) Within the past two years, have you or a family member ever had tuberculosis of the lungs or been in close contact with a person with tuberculosis?
Please Provide Details
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?
Please Provide Your Details
Have you ever been refused a visa or permit, denied entry or ordered to leave Canada or any other country or territory?
Please Provide Your Detail

2)

a) Have you ever remained beyond the validity of your status, attended school without authorization or worked without authorization in Canada?
please provide detail.
b) Have you previously applied to enter or remain in Canada?
Please Provide Your Details
c) Have you ever committed, been arrested for, or been charged with or convicted of any criminal offence in any country or territory?
Please Provide Your Details

3)

a) Did you serve in any military, militia, or civil defence unit or serve in a security organization or police force (including non obligatory national service, reserve or volunteer units)?
please provide dates of service and countries or territories where you served
4) 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?
Please Provide Your Details
5) Have you ever witnessed or participated in the ill treatment of prisoners or civilians, looting or desecration of religious buildings?
Please Provide Your Details

If you answered “yes” to any of questions 3 to 6 above, or upon request of a visa officer, you MAY BE REQUIRED to fill out IMM 5257 Schedule 1

I declare that information given in this application is truthful, complete and correct.

All information provided in this form will remain strictly confidential and secure. It will not be shared with any external sources except the educational institution and Citizenship and Immigration Canada. This information will be used for the sole purpose of securing your possible TRV to Canada. In addition to the assessment form, you may send an updated resume or curriculum vitae, if available, as an attachment to our email address at agentstudent@yahoo.com

Date:
Signature:

Information provided to our firm is strictly Private & Confidential.

keyboard_arrow_leftPrevious
Nextkeyboard_arrow_right