Forms: easy on-line immigration assessment for free!

D&G Europe Consulting
421 Gilmour St., Suite 201
Ottawa , Ontario K2P0R5
Canada
Fax: (613) 730-7023 Tel: (613) 230-7207
E-mail: DGEurope@bellnet.ca
Website: www.mycanadaimmigration.com


Email us!

PRELIMINARY ENQUIRY QUESTIONNAIRE
(All information will be kept confidential)

You may receive the French and the Romanian versions of this form by writing to:
E-mail: sales@mycanadaimmigration.com

Complete one form for each spouse. Si vous préfériez de remplir notre questionnaire en français, envoyez-nous un courriel à l'adresse d'en haut.

Please fill out the fields or check the appropriate boxes. PLEASE USE CAPITAL LETTERS!
All questions must be answered. We will contact you if the assessment is positive. If not, we will store your data in our computer until a favorable change occurs so that we can resume the process of your immigration. Do not hesitate to contact us in six months time, in the event that you have not received a reply, and inquire about possible changes in the Canadian immigration legislation.

NOTE: From time to time, we select clients for processing without any initial fee. We will charge them only after the application has been approved by the Canadian Immigration Authorities. Even for those who will not benefit of this facility, the major part of our fees are only payable when their application has been successful.

Date:
Recommended by:

GENERAL INFORMATION

Family Name:
Given Name:
Address:
E-mail:
Home phone:
Fax:
Business phone:
Date of Birth (dd/mm/yyyy):
Citizenship:
Gender:	Male Female
Marital Status:	Never MarriedMarried Separated Divorced Widowed
Number of unmarried children:
How many are over 22 years?
How many are between 13 and 17?
How many are under 13?
Have you or your immediate family ever been refused a visa/admission to any country?	Yes No
Have you or your immediate family ever had any contagious or chronic illness that required long term treatment or special care?	Yes No
Do you or your immediate family have a criminal record?	Yes No
If the answer to any of the last three questions is "Yes", please give details:

RELATIVES IN CANADA

Do you have any of the following relatives who are residents or citizens of Canada? Please check as appropriate.	Parents Brother Sister Aunt Nephew Niece Cousin No relatives
Others, including friends (specify relationship)
Canadian province where your relative lives
Have you ever visited Canada? (indicate date, duration, location and reason):

LANGUAGE ABILITY
(Please check the appropriate box)

French
Speaking	High Proficiency	Moderate Proficiency	Basic Knowledge	Not at all
Reading	High Proficiency	Moderate Proficiency	Basic Knowledge	Not at all
Writing	High Proficiency	Moderate Proficiency	Basic Knowledge	Not at all
Comprehension	High Proficiency	Moderate Proficiency	Basic Knowledge	Not at all

English
Speaking	High Proficiency	Moderate Proficiency	Basic Knowledge	Not at all
Read	High Proficiency	Moderate Proficiency	Basic Knowledge	Not at all
Write	High Proficiency	Moderate Proficiency	Basic Knowledge	Not at all
Write	High Proficiency	Moderate Proficiency	Basic Knowledge	Not at all

EDUCATIONAL BACKGROUND

Secondary School
Name and Location:
Profile (specialty):
Number of years attended:
From (month/year)
To (month/year):
Name of Diploma/Certificate obtained:
University
Name and Location:
Number of years attended:
From (month/year):
To (month/year):
Degree, Diploma or Certificate (complete name of the document):
Profile indicated on document:
Specialty indicated on document:
Vocational/Technical School
Name and Location:
Number of years attended:
From (month/year):
To (month/year):
Diploma or Certificate (complete name of the document):
Major subject area studied:

Do you have any other training?	Yes No

If "Yes", describe the location, duration, and type of training (please mention any kind of apprenticeship or On-The-Job Training)
Total number of years of full-time studies (including elementary school):

NET WORTH
Please note that the Canadian Immigration Authority expect you to posses appropriate
settlement funds when landing in Canada, in order to support yourself and your family
until you secure steady employment

Cash/Near Cash Assets:
Currency:
Location of Funds:
Property (include the value of all significant movable & immovable goods)
Total funds available for transfer to Canada (in US dollars)

DETAILED WORK OR BUSINESS EXPERIENCE
(for the last 10 years)

Present position or occupation title:
Company/business name:
Country and City:
Started working on (day/month/year):
Profile of the company/business:
Number of employees you supervise:
Please describe your personal responsibilities. Be very specific and keep in mind that this is a very important component of your assessment. Please indicate, if applicable, the tools and the type of equipment you are using.

Previous position or occupation title:
Company/business name:
Country and City:
From (month-year):
To (month-year):
Profile of the company/business:
Number of employees you supervised:
Please describe your personal responsibilities. Be very specific and keep in mind that this is a very important component of your assessment. Please indicate, if applicable, the tools and the type of equipment you were using.
Please indicate any other jobs (title and duration) you have had over the last 10 years, including main responsibilities:
Describe in detail your business experience (as an owner and/or a manager) over the last 5 years, if applicable:

WE ARE LOOKING FOR AGENTS TO MARKET OUR SERVICES OVERSEAS . PLEASE EMAIL YOUR C.V. TO:

DandGEuropeConsulting@bellnet.ca or

President@mycanadaimmigration.com

Preference will be given to owners and/or managers of companies that work with the public at large, such as travel agencies, bookstores, restaurants, hotels, service centres, coffee shops, etc.

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