QUESTIONNAIRE For SKILLED WORKER APPLICANTS Northern Gate Consulting(NGC) Immigration Solutions

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PRE-APPLICATION QUESTIONNAIRE

For

SKILLED WORKER APPLICANTS

(EDUCATED & PROFESSIONAL)

PART 1: INFORMATION ABOUT THE PRINCIPAL APPLICANT

NAME:


First Name:			Middle Name:
Last Name:


Current Address:
Postal Code:


Telephone Nos.
Home:		Work:
Fax:		email :


Sex:	Male	Female

Marital Status:
Single	Married	Engaged	Separated	Divorced	Widowed


Date of Birth:
Day:		Month:		Year:

Place Of Birth:
City/Town:		Province/State:		Country:


Citizen of:	1	2
Permanent Resident of:	1	2
Temporary Resident of (student/work visas, etc.):


Languages:
English:

	Speaking	Reading	Writing	Listening
High Proficiency
Moderate Proficiency
Basic Proficiency
No Proficiency


French:
	Speaking	Reading	Writing	Listening
High Proficiency
Moderate Proficiency
Basic Proficiency
No Proficiency
Other Languages:

Previous Visit to Canada:

From:	Day:	Month:	Year:
Till :	Day:	Month:	Year:

Purpose Of Visit:
Work	Study	Business Trip	Visit


Level of Education:
Secondary or less		High School Diploma		2 years College
3 years College		Bachelor Degree		Masters Degree
PhD.

Major of your Education:
Any other education/training you received? Please specify with dates, diplomas and/or certificates received and the length of program(s):


Your Current Occupation:
Years of working experience in this occupation:


Your other Employment Background:

a) Business/Employment one:
Business/Occupation/Position/Place:
Date Started:		Date Finished:

b) Business/Employment two:
Business/Occupation/Position/Place:
Date Started:		Date Finished:

c) Business/Employment three:
Business/Occupation/Position/Place:
Date Started:		Date Finished:


Any Relatives in Canada?	Yes	No
If yes, please specify the type of relationship:


Any Canadian Work Experience	Yes	No
If yes, please give of the length and type of employments:


Any Canadian Education:	Yes	No
If yes, please specify the type of studies and the Diploma/degree earned:


Any Canadian Pre-Arranged Employment (Confirmed by HRDC):
Yes No
If yes, please specify the type of studies and the Diploma/degree earned:


PART 2: INFORMATION ABOUT YOUR SPOUSE/COMMON-LAW PARTNER (husband/wife) AND OTHER FAMILY MEMBERS:


His/Her Date of Birth:
Day:		Month:		Year:
His/Her Place of Birth:
City/Town:		Province/State:		Country:


She/He is a Citizen of:	1	2
She/He is a Permanent Resident of:	1	2
She/He is a Temporary Resident of (student/work visas, etc.):


Her/his Proficiencies in the Official Languages
English:

	Speaking	Reading	Writing	Listening
High Proficiency
Moderate Proficiency
Basic Proficiency
No Proficiency


French:
	Speaking	Reading	Writing	Listening
High Proficiency
Moderate Proficiency
Basic Proficiency
No Proficiency
Other Languages:

His/Her Previous Visit to Canada:

From:	Day:	Month:	Year:
Till :	Day:	Month:	Year:

Purpose Of Visit:
Work	Study	Business Trip	Visit


His/Her Education:
Secondary or less		High School Diploma		2 years College
3 years College		Bachelor Degree		Masters Degree
PhD.

His/Her Major of Studies:
Any other education/training she/he received? Please specify with dates, diplomas and/or certificates received and the length of program(s):

His/Her Current Occupation and years of experience in this occupation:


His/Her other Employment Background:

a) Business/Employment one:
Business/Occupation/Position/Place:
Date Started:		Date Finished:

b) Business/Employment two:
Business/Occupation/Position/Place:
Date Started:		Date Finished:

c) Business/Employment three:
Business/Occupation/Position/Place:
Date Started:		Date Finished:


Does She/He have any relatives in Canada?	Yes	No
If yes, please specify the type of relationship:


Does She/He any Canadian Work Experience	Yes	No
If yes, please give of the length and type of employments:


Does She/He any Canadian Education:	Yes	No
If yes, please specify the type of studies and the Diploma/degree earned:


Does She/He any Canadian Pre-Arranged Employment (Confirmed by HRDC):
Yes No
If yes, please specify the type of studies and the Diploma/degree earned:


Number of Children :
a) Age :		Sex :		Grade :

b) Age :		Sex :		Grade :

c) Age :		Sex :		Grade :

d) Age :		Sex :		Grade :

Do you or any member of your family has a Serious Disease and or Mental or Physical Disorder?
Yes	No
If yes, who and what disease: