General Inquiries:

Mr. or Mrs. or Ms.
Contact name
Citizenship (s)
Current country of Residence
Legal status in the current country of residence
If temporary resident, please indicate your visa’s expiry date
Legal Status in Canada, if applicable
If temporary resident, please indicate your visa’s expiry date, type of permit
Main telephone number
E-mail
Date of birth
EDUCATION
Educational degree(s): Please give full details of all primary, secondary and post-secondary (university, college, apprenticeship training) studies you have had. Please indicate the country where you have studied, and the period of time (mm/yy)
Do you hold a Canadian diploma? If yes, please provide details on the diploma and length of the program.
WORK EXPERIENCE
Please provide a detailed list of the work experience you had during the last 10 years: position, month/year, specify country, full time/part time
Do you have a permanent, full-time job offer from a Canadian employer? If yes, provide details:
Do you hold a valid work permit for Canada? If so, please provide:
- Expiry date
- NOC code, if applicable
KNOWLEDGE OF ENGLISH AND FRENCH
Have you taken an ENGLISH test (IELTS or CELPIP)? If so, please indicate which test and how long ago.
Please list your language abilities on all four bands:
Speaking
Listening
Reading
Writing
If you haven’t taken any language test what do you rate your level to be from 1 to 9?
Have you taken a FRENCH test? If so, please indicate which test and how long ago.
Please list your language abilities on all four bands:
Speaking
Listening
Reading
Writing
If you haven’t taken any language test what do you rate your level to be from 1 to 9?
Relatives in Canada which are Canadian citizens or Permanent Residents, if applicable
(Please specify if: spouse or common-law partner, child/grandchild, parents/grandparents, sister/brother, uncle/aunt, niece/nephew. Do not include other relatives.)
- Province
- Relatives legal status
Have you travelled, worked or studied in Quebec?
If so, please provide details
Do you have any health issues? Please provide details
Have you had any criminal convictions? Provide details
CHILDREN
Number of children under 12:
Number of children under 19:
SPOUSE/COMMON-LAW PARTNER, IF APPLICABLE
Mr. or Mrs. or Ms.
Spouse’s Name
Spouse’s Nationality (ies)
Current country of Residence
Legal status in the current country of residence
If temporary resident, please indicate the visa’s expiry date
Legal Status in Canada, if applicable
If temporary resident, please indicate your visa’s expiry date, type of permit
Date of birth
SPOUSE’S EDUCATION
Educational degree(s): Please give full details of all primary, secondary and post-secondary (university, college, apprenticeship training) studies you have had. Please indicate the country where you have studied, and the period of time (mm/yy)
Do you hold a Canadian diploma? If yes, please provide details on the diploma and length of the program.
Have your foreign degrees been evaluated for Canadian Educational Credential Assessment? If yes, what was the outcome?
SPOUSE’S WORK EXPERIENCE
Please provide a detailed list of the work experience you had during the last 10 years: position, month/year, specify country, full time/part time
Do you have a permanent, full-time job offer from a Canadian employer? If yes, provide details:
Do you hold a valid work permit for Canada? If so, please provide:
- Expiry date
- NOC code, if applicable
SPOUSE’S KNOWLEDGE OF ENGLISH AND FRENCH
Have you taken an ENGLISH test (IELTS or CELPIP)? If so, please indicate which test and how long ago.
Please list your language abilities on all four bands:
Speaking
Listening
Reading
Writing
If you haven’t taken any language test what do you rate your level to be from 1 to 9?
Have you taken a FRENCH test? If so, please indicate which test and how long ago.
Please list your language abilities on all four bands:
Speaking
Listening
Reading
Writing
If you haven’t taken any language test what do you rate your level to be from 1 to 9?
Relatives in Canada which are Canadian citizens or Permanent Residents, if applicable
(Please specify if: spouse or common-law partner, child/grandchild, parents/grandparents, sister/brother, uncle/aunt, niece/nephew. Do not include other relatives.)
- Province
- Relatives legal status
Have you travelled, worked or studied in Quebec?
If so, please provide details
Do you have any health issues? Please provide details
Have you had any criminal convictions? Provide details

Observations:

5000 Yonge Street Suite 1901, Toronto, Ontario, Canada, M2N7E9
Phone #: 1-416-840-6570 Fax #: 1-416-352-7412 e-mail: www.immigrationpros.ca