Immigration Application Evaluation Form for Independent Class Applicants

Please fill out and send us this form to receive a preliminary estimate for the prospect of your immigration application, free of charge.

Your submission will be evaluated by an immigration consultant, lawyer or Canadian immigration authorities if necessary. When you are done filling out this form, please click the Submit button at the end of the document. To help us best serving you, we would appreciate if you could provide as much information as possible.

Please note that the evaluation will be sent to you at the email address which you provide.

Personal information

Family name:	First name:
Original name (if applicable):	Sex:
Date of birth (dd/mm/yy):	Marital status:
Telephone number (with area code) Home: Preferred time to be reached:	Business: Preferred time to be reached:
E-mail address (evaluation will be sent to you at this address):
Mailing address (if this address contains Chinese characters, you can encode it only with GB code):
In which country are you now? With what status (eg birth)?	Date of entry to this country (DD/MM/YY): What is your citizenship?
What is your occupation and specialty?	When will your passport expire?
How many children do you have?	Age of each child (if applicable):
Do you have relatives in Canada?	If you wish that we contact them please provide their telephone #:

Academic Background

What is the highest degree you obtained or currently pursuing?

Where did or will you obtain this degree?

What's the starting and ending date of this degree?

What is your major field of study (if applicable)?

Please list degree(s) or diploma(s) you obtained in the order that you received, along with institution, location, and field of study.
Example:
Master degree, Computer Engineering
06/21/1996, MIT, Boston, MA, USA

Please list major awards or honour you have received:

Professional Experience

Please list your working history in the past ten years. It would be greatly helpful if you provide as much information as you can, such as employment duration, employer, country, position and brief description of projects.
Example:
Jun. 1994 - Aug. 1995, IBM, Toronto, Canada
Database Programmer
- Designed a database system for OS/2
- Involved in the specification of a desktop e-mail system

Please list other relavant trainings, skills and knowledge you have:

Language

	Fluently	Well	With difficulty	Not at all
English
Speak:
Read:
Write:
French
Speak:
Read:
Write:

Additional Comments

If you have any additional comments, please tell us:

Do you want a copy of this questionaire sent to you (via email) for later reference?

Yes No

Thank you for filling out this form. We will send you the evaluation result by e-mail as soon as we can. Please go over all the information you have provided, and click the Submit button to send it to us.

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