To obtain a free assessment of your eligibility please ...



Free Assessment for Study in Canada

Please mention [Yes] where ever applicable in the brackets [ ] provided

|Student Assessment Form |

|Personal Information: |

|Last Name: |First Name: |Middle Name: |

| |House No: |Street: |City: |

|Mailing Address | | | |

| | | | |

| |State: |Country: |Postal Code: |

| | | | |

|Telephone |Home: |Business: |

| |Fax: |Mobile: |

| |Email: | |

| |

|Date of Birth |Day: |Month: |Year: |Sex: |

|Place of Birth |City: |State: |Country: |

|Citizenship: | |

|Passport |Passport Number: |Passport Issued on: |Passport Expires on: |

| | | | |

|Marital Status: Mention | |Engaged [ ] |Married [ ] |

|[Yes] where relevant: |Never Married | | |

| |[ ] | | |

| |Widowed [ ] |Separated [ ] |Divorced [ ] |

| |Spouse Information |

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

|Full Name: | |

|Date of Birth |Day: |Month: |Year: |Sex: |

|Place of Birth |City: |State: |Country: |

|Citizenship: | |

|Passport |Passport Number: |Passport Issued on: |Passport will Expire on: |

| | | | |

|Occupation: | |

|Experience: | |

|Marriage Date |Day: |Month: |Year: |Place: |

| | |

| |Family Information |

|Children |Full Name |Date of Birth |Son |Daughter |

| | | |[ ] |[ ] |

| | | |[ ] |[ ] |

| | | |[ ] |[ ] |

| |Total number of Children below 22 years of Age: [___years] |

| |Total number of Children above 22 years of Age : [___years] |

| | |

| |Relatives In Canada |

|Do you/your spouse have relatives living in Canada?:Mention Yes/No: | [ ] |

|Name: |Relationship: |Status in Canada: |

| | | |

| | | |

| |Education |

|Education Info | |

|Period |Name & Address of Institutions |Courses: | % |Degree /Diploma/ Certificate |

| | | | |Issued: |

|From: |To: | | | | |

| | | | | | |

| | | | | | |

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|Mention any other related Educational experience that you have in the space provided below: |

|Total Years of Education successfully completed | [_______Years] |

| | |

| |Employment |

|Work History | |

|Date |Name & Address of Employer: |City & Country: |Job Designation: |

|From: |To: | | | |

| | | | | |

| | | | | |

| | | | | |

| | | | | |

| | | | | |

|Detailed Responsibilities &|List duties & responsibilities of each position at previous employment. |

|Duties: | |

|Trade or Profession |Current Occupation: |NOC Number: |

| | | |

|Job Description: |Please attach a separate sheet giving a detailed description of the job responsibilities performed by |

| |you on a day to day basis: |

|Total Work Experience: |How many years of Work experience do you have in the last 10 years? |

|Mention Yes/No: |0 [ ] |

| |1 [ ] |

| |2 [ ] |

| |3 [ ] |

| |4 & Up [ ] |

| | |

|Intended Job In Canada: | |

| |LANGUAGES |

|Language Ability |Please indicate your ability to communicate in English and French by checking the appropriate column |

| |Mention [Yes] where applicable: |

|English |Speak |Read |Write |Understand |

| |[ ] |[ ] |[ ] |[ ] |

| | |

|French |Speak |Read |Write |Understand |

| |[ ] |[ ] |[ ] |[ ] |

| | |

|Language Test |Have you or could you pass a formal English/French Language Test? Mention Yes / No : |

| |English: [ ] |French: [ ] |

| |Language Test Results |

|English |IELTS | | | |

|Overall Score |Listening |Reading |Writing |Speaking |

| | | | | |

|French | | | | |

|Overall Score |Listening |Reading |Writing |Speaking |

| | | | | |

|Other Tests: |GRE: |GMAT: |Other: |

| | |

| |Canada Study Plan |

|Area of Study |Desired Course of study in Canada: |

|Institution | |

| |Course Preference: Mention [Yes] where applicable: |

|Course Type |Diploma: [ ] |Bachelors: [ ] |Masters: [ ] |Doctorate: [ ] |

| | |

|Period of Study |Year: |Month: |Day: |

| | | | |

|Time Frame |Expected time frame you would like to reach Canada?: Mention [Yes] where applicable: |

| |6 Months [ ] |1 Year [ ] |1 ½ Year [ ] |2 Years [ ] |

|FINANCES: |

|Sources of Financing |Own Funds [ ] | |Relatives [ ] |Savings [ ] |

| | |Parents [ ] | | |

| |Bank Loan [ ] |Sponsorship |Scholarship [ ] |Other [ ] |

| | |[ ] | |______ |

|Settlement funds |Do you have sufficient Financial support to cover the cost of Tuition and Living expenses for the first|

| |year? Mention [Yes] where applicable: |

| |More than Cdn $ 10,000 [ ] |Over Cdn $ 20,000 [ ] |

|Cdn $ |Total Funds available for my Study & Stay in Canada. |

| | |

|Net Worth |Bank: |

| |Property: |

| |Assets: |

| |Other: |

| |Total: |

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|If others give details here: |

| |Additional Information |

|Visit Abroad |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? |

| |[ ] |

| |[ ] |

| |[ ] |

| |[ ] |

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| | |

| |PRIOR APPLICATION TO CANADA |

| |Have you ever visited Canada? Mention Yes / No | [ ] |

|Who did you visit |Where: |When: |Purpose: |

| | | | |

| |Have you ever studied in Canada? Mention Yes / No: | [ ] |

|If yes, give details: |Name of Institution: |Course of study: |Date: |

| | | | |

| |Have you ever worked in Canada? Mention Yes / No: | [ ] |

|If yes, give details: |Name of Employer: |Occupation: |Date: |

| | |

|Have you ever been refused a Visa? Mention Yes / No: | [ ] |

|If yes, provide details: |

|Why Canada? |Briefly explain your interest of Studying in Canada?: |

| | |

|Would you be interested in becoming a Permanent Resident in Canada after your study?: Mention Yes / No / Not Sure. [ ] |

|Other Comments |Any other information you believe that is relevant to this assessment? |

| | |

|Why Us? | |

|How did you come to know about our Immigration Consultancy firm? Mention [Yes] where applicable: |

|Referral [ ] |Friend [ ] |Seminar [ ] |

|Newspaper [ ] |Internet [ ] |Other [ ] _________ |

| |PASTE RESUME HERE (Optional) |

| |

|In addition to the Assessment form you may send an updated Resume or Curriculum vitae, if available, as an attachment to our email |

|info@ |

|DECLARATION | |

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|I agree that the information furnished by me in the above form is true and correct, to the best of my knowledge, and given for the |

|sole purpose of my FREE assessment regarding Studying in Canada. (YES/NO) |

| |

|Date: |

|Place: |

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|All information provided in this form will remain strictly confidential and secure. It will not be shared with any external |

|sources. This information is used for the sole purpose of preliminary assessment of your chances to successfully immigrate to |

|Canada. Please see our Privacy Policy. |

| |

|Thank You! |Information provided to our firm is strictly Private & Confidential. |

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