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Free
assessment for people interested in studying in Canada. |
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1.Contact
Information |
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Family
Name
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First
Name
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Phone
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Email
You must enter a valid email address here. |
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2.Principal
Applicant (fill dotted area only if different from Contact
Information) |
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Family
Name
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First
Name
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Phone
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Email
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Current
Mailing Address
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Permanent
Mailing Address
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Current
Occupation
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Name
and address of current Employer or School
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Status
in country where currently living
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If
you have Temporary Status: Date of Visa Expiry. (DD/MM/YYYY)
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Gender
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Marital
Status
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Date
of Birth (DD/MM/YYYY)
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Place
of Birth (city, country...)
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Citizenship
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City
, Country where you are living now
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Passport
Number
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Passport
Expiry Date (DD/MM/YYYY)
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Passport,
Country of Issue:
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Accepted
at following educational institution in Canada:
Canadian currency $ |
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Tuition |
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Room
and Board |
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Other
Expenses |
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Funds
available for my stay in Canada |
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Source
of Financing |
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3.Spouse
and Children Accompanying Principal Applicant |
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A |
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Family
Name
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First
Name
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Relationship
to Principal Applicant
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Date
of Birth (DD/MM/YYYY)
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Place of Birth
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Citizenship
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Passport
Number
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Passport
Expiry Date (DD/MM/YYYY)
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Passport,
Country of Issue
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B |
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Family
Name
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First
Name
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Relationship
to Principal Applicant
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Date
of Birth (DD/MM/YYYY)
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Place
of Birth
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Citizenship
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Passport
Number
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Passport
Expiry Date (DD/MM/YYYY)
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Passport,
Country of Issue:
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C |
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Use
following space for additional family members
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4.Admisibility
Criteria |
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Have
you, or any members of your family ever (If yes, check box): |
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a)
Been treated for any serious physical or mental disorders or
any communicable or chronic diseases? |
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b)
Committed a criminal offence in any country? |
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c)
Been refused admission to or ordered to leave Canada? |
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d)
Been refused a visa to travel to Canada? |
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e)
In periods of either peace or war, have you ever been involved
in the commission
of a war crime or crime against humanity? |
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If
you checked any of the above, please provided detailed explanations
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During
the past five years have you or any family member accompanying
you live in any other country other than your country of citizenship
or permanent residence for more than six months? Provide Details
Below:
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5.Comments
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By
submitting the above answers, I declare that I have answered
all the required questions in this application fully, truthfully,
and to the best of my ability. I waive all present and future
liability on evaluations provided by Samintel technologies Inc. has I understand
that my case assessment will be based on the above answers
that I have provided. |
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