Immigration Questionnaire

Instructions

Type in your answers to the questions below.  When you are finished press the "Send Information Now" button.  You can make changes to any of the information at any time.  To start over again press the Clear button at the bottom of the page.

If you are married, complete the form and press the "Send Information" button, then the "Clear" button.  Enter your spouse's information and press the "Send Information button.

Name - Last, Given, Other Names Used
Street address
Address (cont.)
City
State/Province
Postal code
Country
Work Phone
Home Phone
FAX
E-mail

Please identify and describe yourself:

Sex	Male Female
Date of birth		Place of Birth
Marital Status	Single Married Divorced Widowed Separated    (If you are married please complete one questionnaire for yourself and one for your spouse)
No. of Children
Citizenship

Ability in English	Speak	Read	Write	Listen
	Fluently Well With difficulty Not at all	Fluently Well With difficulty Not at all	Fluently Well With Difficulty Not at all	Fluently Well With Difficulty Not at all

Ability in French	Speak	Read	Write	Listen
	Fluently Well With difficulty Not at all	Fluently Well With difficulty Not at all	Fluently Well With Difficulty Not at all	Fluently Well With Difficulty Not at all

Have you had your

Yes No

 

Name and address of closest relative in Canada:
Relationship
Relative's Status in Canada

 

Education		# of years
	primary school
	High School
	College/university
	Trade School
	apprenticeship

 

Does your high school qualify you to attend university?

Did your high school courses include vocational training?

(Give details)

Details of any college or university degrees obtained:

Details of any specialized job training (ie vocational school or apprenticship:

Net worth(all assets including money, land,stocks,bonds,cars,jewellery,shares in your business minus all debts):

Work History/business experience for the last 10 years:

1.

From to

Employer/buisness:

Gross monthly salary:

Position/occupation:

Description of Duties (Describe in detail and specify management experience, if any):

What business does this company do:

How many employees:

Gross annual volume of business:

Do you own all or part of this business:

What is you share:

How much money have you invested:

 

2.

From to

Employer/buisness:

Gross monthly salary:

Position/occupation:

Description of Duties (Describe in detail and specify management experience, if any):

What business does this company do:

How many employees:

Gross annual volume of business:

Do you own all or part of this business:

What is you share:

How much money have you invested:

 

3.

From to

Employer/buisness:

Gross monthly salary:

Position/occupation:

Description of Duties (Describe in detail and specify management experience, if any):

What business does this company do:

How many employees:

Gross annual volume of business:

Do you own all or part of this business:

What is your share:

How much money have you invested:

4.

To add more work history please enter the information in the scrolloing box below in the same order as the above information:

Additional Information not elsewhere specified