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Thank you for giving us opportunity to assess your eligibility for immigration to Canada. It is very important to fill out every section of this form appropriately.
Please note that this is a preliminary assessment form. We reserve the right to ask for more information regarding your matter in the future. Any opinion given by us based on the information you are providing in this form, in no way warrants, represents, guarantees your full eligibility for immigration to Canada. Please also note that the information you will provide in this form will not create attorney-client relationship between us, unless you retain us to proceed with your matter. We reserve the right to verify your information, if necessary, from any third party. We will assess your information at this stage at no charge and will get back to you as soon as possible after you have submitted this assessment form. Please fill out every section of this form; if any section in this form does not apply to you, just insert “n/a” or “none”. If you have any question, concern, please contact us by sending your inquiries at the Contact Us page. |
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| A. Applicant’s Personal Information | ||
| 1) Title: |
2) Family/Surname: |
3) First Name: |
| 4) Middle Name: |
5) Gender: |
6) Current address: |
| 7) Mailing address (if different than above address): |
8) Country: |
9) Phone number (including Country code): |
| 10) Fax number: |
11) E-mail address: |
12) Date of birth: |
| 13) Place of birth: |
14) Country of birth: |
15) Current Citizenship: |
| 16) Passport Number: |
17) Marital status: | |
| 17-a) If Divorced, date of Divorced: |
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| 17-b) If married, date of Marriage: |
17-c) If Separated, date of Separated: |
18) Number of children: |
| 19) Age of children: | ||
| a. 1st Child: |
b. 2nd child: |
c. 3rd Child: |
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| d. 4th Child: |
e. 5th Child: |
f. 6th Child: |
g. 7th Child: |
| B. Applicant’s Education | ||
| 20) Level of education: | ||
| 21) Total number of years of full time education after grade 10: |
| C. Applicant’s Current Work Experience |
| 22) Current employment status: |
| 23) If employed, how many years: |
24) Current position: |
| 25) Job duties: |
26) Name of the employer: |
27) Work address: |
| 28) Work phone number: |
29) Work fax number: |
30) Work e-mail: |
| D. Applicant’s Previous Employment Experience | ||
| 31) Previous employment position: |
32) Number of years employed in previous employment |
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| 33) Name of the previous employer: |
34) Address of previous employer: |
35) Previous work phone number: |
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| 36) Previous work fax number: |
37) Previous work e-mail number: |
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| E. Applicant’s Language Ability(please write yes or no where appropriate) |
| 38) English: | Write: |
Read:
| Speak: |
| 39) French: | Write: |
Read:
| Speak: |
| F. Spouse/Partner’s Personal Information | ||
| 40) Title: |
41) Family/Surname: |
42) First Name: |
| 43) Middle name: |
44) Gender: |
45) Current address: |
| 46) Mailing address (if different than above address): |
47) Country: |
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| 48) Phone number (including Country code): |
49) Fax number (if any): |
50) E-mail address: |
| 51) Date of birth: |
52) Place of birth: |
53) Country of birth: |
| 54) Current Citizenship: |
55) Passport number: |
56) Marital status: |
| 56-a)If married, date of Marriage: |
56-b)If Separated, date of Separated: |
56-c)If Divorced, date of Divorced: |
| G. Spouse/Partner’s Education: | ||
| 57) Level of education (such as Bachelor, Masters, Diploma etc.): | ||
| 58) Total Year of education: |
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| H. Additional Information for Applicant | ||
| 58. Do you have a job offer from a Canadian employer? | ||
| 59. Do you have HRDC confirmed offer of employment in Canada? |
| 60. Have you worked in Canada for at least one or more in full time? | ||
| 61. Have you studied in Canada for 2(two) years or more full-time authorized post-secondary study? | ||
| 62. Have your spouse worked in Canada for at least one or more in full time? | ||
| 63. Have you spouse studied in Canada for 2(two) years or more full-time authorized post-secondary study? |
| 64. Do you and/or your spouse have any direct blood relative in Canada who is a Canadian Citizen or Permanent Resident? |
| 65. What is the relationship? Indicate relationship |
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| 66. Would your relatives be able to sponsor you? |
| 67. Have you had your English or French language test? | ||
| 68. If yes, which one: |
| 69. What is the Score:Indicate Score |
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| 70. If not, have you had booked your English/French test exam? |
| I. FOR BUSINESS CLASS ONLY (please fill out the above sections A-H PLUS this part you intent to find out your opportunity to apply under Business category) |
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| Applicant’s Financial Information | ||
| For net value, ADD the fair market value of your and/or your spouse or common law partner’s assets and DEDUCT from the value your and/or your spouse, common law partner’s debts, liabilities, if any. | ||
| 71. Do you and/or your spouse legally owned assets the net worth of which is at least CAD$300,000: |
| 72. Do you and/or your spouse legally owned assets the net worth of which is at least CAD$1.6 million: | ||
| 73. Can you confirm by providing evidence that the fair market value of all your assets and the assets of your spouse or common-law partner were obtained legally (by providing income tax return, certificate, proof of inheritance, gift etc.) | ||
| 74. Can you invest CAD 300,000 in Canada? | ||
| 75. Can you invest CAD 800,000 in Canada? |
| Applicant’s Business Experience | ||
| 76. Do you own and operate a business or percentage of a business for at least 2 years within the past five years? |
| 77. If yes, how many years? Indicate number of years |
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| 78. How much is your percentage of ownership (such as full, one half, one third etc.)? Indicate percentage of ownership |
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| 79. Business name: |
80. Your position in the business: |
81. Nature of the business: |
| 82. Phone number: |
83. Fax number: |
84. E- mail address: |
| 85. Business website: |
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| 86. Number of full time employees (i.e. at least 37.5 Hours per week): Indicate number |
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| 87. If yes, does your business have at least CAD$50,000 annual net income: | ||
| 88. If yes, is your business asset net value atleast CAD$125,000? |
| 89. Have you made a business exploration trip to Canada in the five years preceding the date of your application: |
| J. CANADIAN EXPERIENCE CLASS ONLY (please fill out the above sections A-H PLUS this part you intent to find out your opportunity to apply under Canadian Economic category) |
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| 90. Have you taken a test from a designated testing agency to assess your proficiency in English or French: |
| 91. Have you studied in Canada: | ||
| 92. If yes, how many years: |
93. Fulltime: |
| 94. Part time : | ||
| 95. Name of the Educational Institution: |
96. Course & Other Information: |
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| 97. What is your current status: | ||
| 98. Have you previously worked in Canada: |
| 99. If yes, how many years: |
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| 100. Fulltime: | ||
| 101.Part time : |
| 102.Name of the Employer: |
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| 103. Job Title: |
104.Job Duties: |
105.Additional Information: |
| 106. What is your current status: | ||
| K. SELF-EMPLOYED PERSON | ||
| 107. Have you worked in any of the categories at least for 2(two) within last 3 years: | ||
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Producers, Directors, Choreographers and Related Occupations |
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Conductors, Composers and Arrangers |
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Musicians and Singers |
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Dancers |
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Actors and Comedians |
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Painters, Sculptors and Other Visual Artists |
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Library and Archive Technicians and Assistants |
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Technical Occupations Related to Museums and Art Galleries |
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Photographers |
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Film and Video Camera Operators |
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Graphic Arts Technicians |
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Broadcast Technicians |
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Audio and Video Recording Technicians |
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Other Technical and Co-ordinating Occupations in Motion Pictures, Broadcasting and the Performing Arts |
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Support Occupations in Motion Pictures, Broadcasting and the Performing Arts |
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Announcers and Other Broadcasters |
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Graphic Designers and Illustrators |
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Interior Designers |
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Theatre, Fashion, Exhibit and Other Creative Designers |
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Artisans and Craftspersons |
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Patternmakers – Textile, Leather and Fur Products |
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Athletes |
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Coaches |
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Sports Officials and Referees |
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Program Leaders and Instructors in Recreation, Sport and Fitness |
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| 108. Details of the Work: |
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| 109. Do you have at least 2 years of experience as self-employed in cultural activities: |
| 110. Do you have at least 2 years of experience as self-employed in cultural activities: |
| 111. Do you have at least 2 years of experience in the purchase and management of a farm: |
| 112. Details of the Management of the Farm: |
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| L. REFUGEES | ||
| 113. Do you intend to claim refugee status in Canada: |
| 114. Are you currently in Canada: |
| 115. If no, which country you are currently living in: |
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| 116. Are you currently living in your home country: |
| 117. If no, what is the name of your home country: |
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| 118. Do you have citizenship of any other country in addition to your home country? |
| 119. If yes, name of the country you have citizenship with in addition to your home country: |
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| 120. Have you contacted the nearest United Nations High Commissioner for Refugees (UNHCR) for your matter: |
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| 121. If yes, do you have United Nations High Commissioner for Refugees (UNHCR) file number: |
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| 122. Details of the facts on which you want to claim refugee status: |
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| Declaration -Must be completed | ||
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I certify that the information I have provided herewith for the purpose of Free Immigration Assessment Questionaires is accurate. I consent that Nizam Hashmi, Barrister and Solicitor, has the right to verify the information I have provided herewith from any third party and me and to correspond with me or my authorized representative by person, phone, fax, email or any other suitable method regarding this Free Immigration Assessment Questionaires. |
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| ADDITIONAL COMMENT |
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