Immigration Preliminary Inquiry
Questionnaire
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1)GENERAL INFORMATION
Applicants's Inforamtion
Family name
First and middle name
Maiden name(if applicable)
Date of birth
City of birth
Work phone no
Home phone no
Fax Number
Email address
Mailing address
   
Marital Status
Never Married Married Seperated Divorced Widowed
Spouse name and Education
Number of children Employed unemployed
Children ages
Number of unmarried children
   
2)WORK AND BUISINESS EXPERIENCE
Beginning with your present (or last) full-time position and working backwards, please fill the indicated information on each position or business you were involved with. You may use the "Further Information" box below for any additional comments or information that you may think is relevant to your career.
Last Position/Occupation
Position/Occupation/Short description
Organization/Institution
Name of business
Dates (from - to)
Last Salary in US$
Previous Position/Occupation
Position/Occupation
Organization/Institution
Name of business
Dates (from - to)
Further Information on Business and Experience
Further Information
   
3) EDUCATIONAL BACKROUND
Academic Degree(s) Obtained:
(i.e High School, Diploma, Bachelor, Master, Doctorate)
High School
High School name and location
High School year of graduation
University Study and Degrees
University 1
Name and Location
Study Years
Degree and Major
University 2
Name and Location
Study Years
Degree and Major
University 3
Name and Location
Study Years
Degree and Major
University 4
Name and Location
Study Years
Degree and Major
Vocational & Technical Schools
Please give the details of all other qualifications or training below
Training Details
Other qualifications or training
Please describe the location, duration and types of training in the box below
Other Qualifications
Trade or professional licenses held. Please Describe in box below
Licenses Details
   
4) LANGUAGE ABILITY
Applicant Langauge Ability:
English Langauge
  Read Write Speak Listen
High Proficiency
Moderate Proficiency
Basic Proficiency
No Proficiency


French Langauge
  Read Write Speak Listen
High Proficiency
Moderate Proficiency
Basic Proficiency
No Proficiency
   
5) FINANCIAL RESOURCES
How much cash or near cash resources do you have available (in US$)?
Less than US$ 10,000 US$ 10,000 to 20,000 US$ 20,000 to US$ 50,000 More Than US$ 50,000
   
6) RELATIVES IN CANADA
Are any of your following relatives citizens or permanent residents of Canada?
Father Mother Brother(s) Sister(s) Uncles(s) Aunt(s) Nephews(s) Nieces(s) Grandparent(s) Grandchild(ren)
   
7) ADMISSIBILTY
Have you or any member of your immediate family ever been refused a visa/admission to any country, including Canada
No Yes
Have you or any member of your immediate family ever had a contagious or chronic illness that required long-term treatment or special care?
No Yes
Do you or any member of your immediate family have a criminal record or may present a security concern for Canada?
No Yes
Thank You
With the compliment of ACKER CHOUQUETE ADVOCATES BARRISTERS & SOLICITORS