Canadian permanent resident status in Canada, Canadian permanent residency, questionnaire, form



	*Do You Qualify? Permanent Status*

Complete and submit the following questionnaire to obtain a FREE ASSESSMENT. Our experienced immigration lawyers will review and assess your qualifications and will notify you via e-mail within 24 hours.

assessing Canadian permanent residency

FREE Assessment Form

CONFIDENTIAL WHEN FILLED

Please answer all questions completely. If questions are not applicable, indicate by 'N.A.'

Please describe the type of immigration services you require:

Full Name:

Mr. Ms Mrs. Dr.

Current Mailing Address:

City:

Province/State:

Country:

Postal/Zip Code:

Telephone:

Fax:

Email:

Please kindly retype your email address:

Personal Information:

Date of Birth:

Place of Birth (city, province/state, country):

Citizenship:

Martial Status:

	Never Married		Common-Law
	Engaged		Divorced
	Married

If you are married or engaged provide details of your spouse or fiancé(e)
Full Name:
Date of Birth:
Citizenship:
Occupation:
Experience:
Date of Marriage:
Number of years of post secondary education completed?
Do they have a diploma or degree?
If yes, please give details:

FAMILY INFORMATION:

Provide details of all your children:

Full Name	Son	Daughter	Date of Birth

Details of your Relatives in Canada, (describe the relationship clearly such as father's real brother, mother's real sister, etc.)

Name	Relationship	Address

EDUCATION INFORMATION:

Please provide the Educational Record with dates, name and addresses of Institutions attended, courses taken, details of degree/diploma/certificate received. Include all full-time and part-time courses:

PERIOD		NAME & ADDRESS OF INSTITUTIONS	COURSES	DIPLOMA/DEGREE/CERTIFICATE
From	To	NAME & ADDRESS OF INSTITUTIONS	COURSES	DIPLOMA/DEGREE/CERTIFICATE

EMPLOYMENT INFORMATION:

Please provide detailed employment record with dates, names, & addresses of employers and job designations held:

PERIOD		NAME & ADDRESS OF EMPLOYERS	JOB DESIGNATIONS
From	To	NAME & ADDRESS OF EMPLOYERS	JOB DESIGNATIONS

Detailed description of job responsibilities performed since you started working. Please describe the job responsibilities performed by you on a day to day basis in great detail:

Please indicate your ability to communicate in English and French (Please Check the appropriate column)

ENGLISH

	Fluently	Well	With Difficulty	Not at all
Speak
Read
Write

FRENCH

	Fluently	Well	With Difficulty	Not at all
Speak
Read
Write

Have you ever owned and operated your own business?

No Yes
If yes, email a complete business profile of your company to jbomza@canadausvisas.com.

Your current net worth (assets less liabilities) include all bank deposits, property, and other assets:

Your current monthly income:

Have you ever visited abroad? If yes, which countries:

For which countries do you have a valid visitors visa?

Do you have a work visa for any country?

Have you ever studied in Canada? If yes, please give details:

ADDITIONAL INFORMATION:

How did you come to know about our immigration law firm?

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