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APPLICATION FOR PERMANENT RESIDENCE IN CANADA

Name:
EMail:
ID :




 1. First name  :
2. Family name :
3. Sex :Male Female

4. Date of birth (date/month/year) :
5. Place of birth : (country) :
6. I am a citizen of :
7. Current mailing address with Telephone & e-mail :



Q 8 : Present marital status :
never married
married
widowed
separated
divorced


Q 9 : Number of dependants over 19 years of age :



Q 10 : Number of dependants under 19 years of age :



Q 11 : Ability in English - Speak :
Fluently
Well
With difficulty
Not at all


Q 12 : Ability in English - Read :
Fluently
Well
With difficulty
Not at all


Q 13 : Ability in English - Write :
Fluently
Well
With difficulty
Not at all


Q 14 : Ability in French - Speak :
Fluently
Well
With difficulty
Not at all


Q 15 : Ability in French - Read :
Fluently
Well
With difficulty
Not at all


Q 16 : Ability in French - Write :
Fluently
Well
With difficulty
Not at all


Q 17 : Education - Primary & High school - number of years of school completed :



Q 18 : Education - Pre-University - number of years of school completed :



Q 19 : Education - University / College - number of years of school completed :



Q 20 : Education - Apprenticeship / Training - number of years of school completed :



Q 21 : Your present occupation :



Q 22 : Number of years of relevent experience : (please attach CV separately if possible)



Q 23 : Do you have a job offer from a person, employer or Organization in Canada ?
Yes
No


Q 24 : Do you have any close relatives in Canada ? (state relationship)



Q 25 : I have the following assets : (show amount for liquid assets & property separately, value in Canadian Dollars):



 I certify that the information contained in this document is complete, accurate and factual.
 I also realise that this is a preliminary questionaire, and further details may be required
 before a final assessment with a money-back guarantee can be given.

                 ................................................
                 signature                       date

 Upon completion of the form,
 fax to : +9712-728437
 or post to : Post Box 4336, Abu Dhabi, U.A.E.
 or e-mail mcutchi@emirates.net.ae
 or call us on +9712-773823, +97105-6210 750
 
 
APPLICATION FOR PERMANENT RESIDENCE IN CANADA 

 INITIAL ASSESSMENT FORM

  
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            Graphics courtesy :
            Wade Penner, Quicksite
 
Page design & text copyright ã1997-1998 Mubeen A.Cutchi