APPLICATION FOR PERMANENT RESIDENCE IN CANADA INITIAL ASSESSMENT FORM INSTRUCTIONS : To obtain a paper copy, press the 'Print' button from your Browser. To return the form by e-mail, copy & paste this form into a wordprocessor, such as MS Write, MS Wordpad, or MS Word, fill it out, and e-mail to us as an attached file. Or simply insert the copied form into your e-mail body. I am applying for : Permanent Resident Visa / Dependant 1. First name ........................... Family name ......................... 2. Sex male/female .................. 3. Date of birth (day/month/year) .........../........... / ............... 4. Place of birth : (country) ................................... 5. I am a citizen of ............................................ 6. Current mailing address .......................................... ..................................................................... ..................................................................... Telephone : E-mail : 7. Present marital status : never married/married/widowed/separated/divorced 8. Number of dependants over 19 years of age : ...............(excluding spouse) 9. Number of dependants under 19 years of age : ............... 10. Ability in English Speak Fluently / Well / With difficulty / Not at all Read Fluently / Well / With difficulty / Not at all Write Fluently / Well / With difficulty / Not at all 11. Ability in French Speak Fluently / Well / With difficulty / Not at all Read Fluently / Well / With difficulty / Not at all Write Fluently / Well / With difficulty / Not at all 12. Education (indicate number of years of school successfully completed) : Primary & High school .............................. years, Pre-University .................................... years, University / College ............................... years, Apprenticeship / Training ...........................years 13. Details of post-secondary education : Dates Name of Institution Country Type of Qualification including apprenticeship ......................................................................... 14. My present occupation is ............................................ 15. Number of years of relevent experience ................. years Details of employment : (this is essential) Dates Employed as Job duties ........................................................................ (alternatively, you may attach your recent resume) 16. Do you have a job offer from a person, employer or Organization in Canada ? .................................................................................. 17. Do you have any close relatives in Canada ? ................................ (state relationship) 18. I have the following assets (show amount or value in Canadian Dollars): Liquid Assets : CAN............................/= Property : CAN............................/= Other : CAN............................/= If 'Other', give details here ..................................................... ................................................................................... 19. I have the following debts or legal obligations (e.g. child support payments) Amount CAN............................/= 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, post to : 803-80 Forest Manor Road, North York, Toronto, Ontario M2J 1M6, Canada or e-mail mcutchi@canada.com, or fax to : 001 (416) 491 6826 Back to Main Page |
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