1. Name in Full:

            Please refer to Immigration Assessment for Any applicable Fees for providing the Assessment
            Additionally, Payment for the Assessment, which have fees associated, must to be done in Advance 
             or along with Assessment w/Credit Card Payment.

            You may pay by Credit Cards: , OR Please postal mail the fees in US$ funds via a check, 
            money order or certified check to the office. If you needed further instructions please telephone our office.)

2. Country Most Interested in Migrating to or Employment Services:  1st: Please Make a Selection 1st USA, Email Consultation, US$ 25 1st Canada, Email Consultation, Fee US$ 25 1st Canada, Free Email Evaluation, Fee US$ 0 1st Australia, Email Consultation, Fee US$25 1st New Zealand, Email Consultation, Fee US$25 Employment Services USA, specify which one below Employment Services CANADA, specify which one below ,   

What Service(s) are you requesting? 
(Example, Visa service x, or Temporary Work Permit, or 
Assessment For Canadian Permanent Residence etc. Review the types of visas from Web pages earlier):  

Reason for the Above Services (reason to go the country)

 

2nd Country Interested in for Migration or Employment Services: 2nd Country of Migraton or Fee Based Employment , If Any None 2nd USA, Email Consultation, Fee US$ 25 2nd Canada, Email Consultation, Fee US$ 25 2nd Canada, Free Email Evaluation, Fee US$0 2nd Australia, Email Consultation, Fee US$25 2nd New Zealand, Email Consultaiton, Fee US$25 2nd Employment Services USA, specify which one below 2nd Employment Services CANADA, specify which one below ,  

What Service(s) are you requesting? (Example,  Visa service X, or Temporary Work Permit, etc.):  

Reason for the Above Services (reason to go the country, etc.)

 

           

3rd Country Interested in for Migration or Employment Services:  3rd Country of Migration or Fee Based Employment Services , If Any None 3rd USA, Email Consultation, Fee US$ 25 3rd Canada, Email Consultation, Fee US$ 25 3rd Canada, Free Email Evaluation, Fee US$ 0 3rd Australia, Email Consultation, Fee US$25 3rd New Zealand, Email Consultation, Fee US$25 3rd Employment Services USA, specify which one below 3rd Employment Services CANADA, specify which one below

What Service(s) are you requesting? (Example,  Visa service X, or Temporary Work Permit, etc.):   

Reason for the Above Services (reason to go the country, etc.)

 

 

3. Present Address:

    City: , State/Province: , Zip/Pin:

   Country:

4. Phone No's: Home: , Work:

5. Email Id:    Fax:

(Please note: Without a Valid Email Address their is no way for us to contact you)

9. Social Security / Identity Card No, if Any:

10. Current Visa Status or Visa Holding(s), If Any: ,
            Expiry Date of that Visa(s) (mm/dd/yyyy):

12: Dependents:                                             
Total Number of Children:  Please Make a Selection None (Zero) One Two Three Four Five Six Seven Children Eight + Children  

Again do not USE ANY ABBREVIATIONS in any of the fields for this form.

Name of Institution
Location: (Include Complete Street Address,  City, State & Country)	Street: City: State: Country:
Date From:	Date To:
Part Time  Full Time
Degree (example: Yes got High School Diploma)
Special Mentions:

Post Secondary Education (After High School):
Institution #1 (If none,  Skip to: Language Ability ) :

Name of Institution Do not USE ANY ABBREVIATIONS.	Education Institute One
Location: (Include Complete Street Address,  City, State & Country)	Street: City: State: Country:
Date From: (month/year)	Date To: (month/year)
Part Time  Full Time
Degree or Program of Study (Certificate, Apprenticeship, Diploma, Bachelor's, Masters or Ph. D.) : (example: Bachelor of Arts In Economics w/emphasis in Accounting)
Special Mentions:

Institution #2  (If done,  Skip to: Language Ability ) :

Name of Institution
Location: (Include Complete Street Address,  City, State & Country)	Street: City: State: Country:
Date From: (month/year)	Date To: (month/year)
Part Time  Full Time
Degree or Program of Study  (example: Bachelor of Arts In Economics)
Special Mentions:

Institution #3  (If done, Skip to: Language Ability ) :

Name of Institution
Location: (Include Complete Street Address,  City, State & Country)	Street: City: State: Country:
Location (Include Complete Street Address, City, State and Country)
Date From: (month/year)	Date To: (month/year)
Part Time  Full Time
Degree or Program of Study   (example: Bachelor of Arts In Economics w/emphasis in Accounting)
Special Mentions:

Institution #4  (If done, Skip to: Language Ability ) :

Name of Institution
Location: (Include Complete Street Address,  City, State & Country)	Street: City: State: Country:
Date From: (month/year)	Date To: (month/year)
Part Time  Full Time
Degree or Program of Study   (example: Master in Business Administration w/emphasis on Finance)
Special Mentions:

14. Language Ability:    Mother Tongue:  Other Languages:

Fluent: Very Good Command of the Language in range of Social and Work situations, No difficulty in communicating in a professional capacity. Well: Can Communicate Reasonably Well about Personal & Familiar Things. With Difficulty: Command of just Few Basic Words.
English		French
Speak	Ability of Speak English Not at All With Difficulty Well Fluently	Ability of Speak French Not at All With Difficulty Well Fluently
Read	Ability to Read English Not at All With Difficulty Well Fluently	Ability to Read French Not at All With Difficulty Well Fluently
Write	Ability of Write English Not at All With Difficulty Well Fluently	Ability of Write French Not at All With Difficulty Well Fluently

15. If Self Employed (otherwise skip to Question 16: Employment)

    Name of Company:                      
    Owner of Company:                     
    Your % Ownership in Company:    Business Start Date (month/year): 
    Type of Business:                       
   
    Your Role / Duties in the Company:

16.    Employment History:

If Self Employed, Entrepreneur, or Investor, then indicate those as your Occupation, 
OTHERWISE:  If applying for Canada in the Skilled Worker / Independent Visa, or Temporary Worker Category, 
Please make sure your Occupation is listed in Canadian Open Occupations. 

Enter Occupation appropriately, If the occupation is not Listed Then YOU DO NOT QUALIFY, so please check the lists and requirements.

Your Current Occupation: .

Please review List: If applying for Canada in the Skilled Worker / Independent Visa, or Temporary Worker Category, 
Please make sure your Occupation is listed in Canadian Open Occupations.

If the Occupation is Not Listed, and you are Seeking Assessment for Canada, then DO NOT PROCEED Further, As you PROBABLY will NOT Qualify.

Intended Occupation in Country of Migration: .