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Client Assessment Form

Please note that this is a non refundable fee and one of our staff member will contact you via email or phone call to discuss your opportunities to migrate Canada

Personal Information

Name

Email*

Phone*

Age in Years

Date Of Birth

Marital Status*

Current Residential Address

Education History

Canadian Education (if applicable)

College/University Name

From (MM-YYYY)

To (MM-YYYY)

Name of Degree/Diploma

Field of Study

City, Country

Home Country Education (Bachelors, Masters or Diploma, if applicable)

College/University Name

From (MM-YYYY)

To (MM-YYYY)

Name of Degree/Diploma

Field of Study

City, Country

Relatives In Canada

Do you have any Brother/Sister with permanent resident status in Canada?*

List all the family members residing in Canada:

NAME

RELATIONSHIP

CITY AND PROVINCE

Work Experience (If Any)

Please provide the detailed Canadian employment record with date, name and address of employer and job designation held

From (MM-YYYY)

To (MM-YYYY)

Name & Address of Employer

Job Title

Please provide the detailed Home country employment record with date, name and address of employer and job designation held (if applicable)

From (MM-YYYY)

To (MM-YYYY)

Name & Address of Employer

Job Title

English Proficiency

Did you take IELTS exam? (Yes/No)

If Yes, what module "General or Academic" ?

IELTS Score Obtained

Listening

Speaking

Writing

Reading

Overall

If No, when are you planing to take exam ?

Visa Information

Have you ever applied or issued student visa, visitor or PR for Canada or Any Other Country?

Please provide details, date and reason

Have you ever refused student visa, visitor or PR for Canada or Any Other Country?

Please provide details, date and reason

Did someone refer you to us?

Choose Your Consulting Option*

Client Assessment Form

Personal Information

Education History

Relatives In Canada

Work Experience (If Any)

English Proficiency

Visa Information

DHALIWAL Immigration Solutions

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