Personal Information

QUESTIONNAIRE

For a free assessment of your qualifications to obtain a Canadian permanent resident visa, please complete this form. Should we require further information to complete our assessment, we will ask you accordingly.

Information about the Main Applicant
Personal Information:
Name:
Email:
Age:
Country of birth::
Country of residence:
Marital status:
Highest Education:
Field of Studies:
Name of Educational Institution:
City, Country:
Knowledge of Languages:
English
French
Occupation: Please specify in the space below 3 of your most recent occupations (jobs).
Years of experience	Occupation Title



Relatives: Do you have a brother, sister, mother, father, grandparent, aunt, uncle, niece or nephew who is a permanent resident or Canadian citizen living in Canada?
	Yes No
Financial resources: How much money can you bring with you to Canada?
CDN$

Business: Do you have business management experience?
	Yes No

Other Information
Do you have a job offer in Canada?	Yes No
Have you ever worked in Canada?	Yes No
Have you ever studied in Canada?	Yes No
Have you ever been in Canada?	Yes No
Have you ever been a Canadian Citizen/Immigrant?	Yes No

Have you or a dependant been treated (or are still under treatment) for any physical or mental disorder?	Yes No
Have you or a dependant ever been denied entry to ANY country?	Yes No
Have you or a dependant ever been charged with or convicted of a criminal offence?	Yes No
Have you or a dependant ever been accused of being a member of a terrorist organization or of committing human rights violations?	Yes No

If you need to add more information, please use the space below to tell us about other things we need to know about you.