Email *
Where did you hear about us OR name of person who referred you to our program *
Geraldine / Ghie Gibi / George Tatum Seno Facebook, Linkedin, Instagram or other social media platform Others
If your answer to the last question is OTHERS, please fill this in or put N/A if not applicable
What made you decide to consider us to possibly represent you in your Canadian immigration application?
PRINCIPAL APPLICANT Information
Full Name
Email *
Phone number *
Complete home address *
Date of Birth *
Country of Birth *
Country of Residence if different from country of birth *
Do you have a valid passport? *
Passport Date of Issue *
Passport Expiry Date *
OFFICIAL LANGUAGES PROFICIENCY The following are accepted by the IRCC:
Have you taken an English language test? *
Type of English test
Choose IELTS General IELTS Academic CELPIP General CELPIP Academic
Date of Test
Test results (Reading, Writing, Speaking, Listening)
Upload your language test report
Have you taken a French language test? *
Type of French language test
Choose TEF Canada TCF Canada
Date of Test
Test results (Reading, Writing, Speaking, Listening)
IMMIGRATION PATHWAYS (Choices)
If you are considering "Visit Canada", what is your intention of visiting Canada? Do you have a relative or friends in the country? *
Personal Information
Marital Status *
Choose Single Married Common-Law Conjugal Partner
Date of Marriage / Cohabitation
Is your spouse / common-law / conjugal partner immigrating to Canada with you?
Do you have dependent child/ren? *
How many dependent child/ren do you have? *
Choose 0 1 2 3 4 5 Put the number if more than 5
Please list age/s of your children:
Have you ever worked, studied or visited Canada? *
If your answer is YES to the last question, what type of visa / permit were you granted for? Please provide more details as you can (inclusive dates of stay in Canada).
Do you have active application with the IRCC or sign up with another RCIC/Immigration Lawyer or Agency?
If your answer is YES to the last question, please give more information. What is your CRS score if it is through the Express Entry?
Please name all countries you have lived in for 6 months or more since the age of 18.
Do you or your spouse / common law partner have any close family members or friends who are temporary resident, permanent resident or citizen of Canada and is LIVING IN Canada?
If you answered YES to the above question, please state the relationship
Choose Parent/s Singling/s Aunt/Uncle First Counsin/s Friend/s
Province or territory where your relative/friend is living in:
Choose Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Ontario Prince Edward Island Quebec Saskatchewan Northwest Territories Nunavut Yukon
Education
Level of Education * Less than secondary school (high school) Secondary diploma (high school graduation) One-year degree, diploma or certificate from a university, college, trade or technical school, or other institute Two-year program at a university, college, trade or technical school, or other institute Bachelor's degree OR a three or more year program at a university, college, trade or technical school, or other institute Two or more certificates, diplomas, or degrees. One must be for a program of three or more years Master's degree, OR professional degree needed to practice in a licensed profession (For “professional degree,” the degree program must have been in: medicine, veterinary medicine, dentistry, optometry, law, chiropractic medicine, or pharmacy.) Doctoral level university degree (Ph.D.)
Other:
Area of studies *
Do you have education credential assessment (ECA) through WES, IQAS, etc.? *
Date of education credential assessment report
Upload your Education Credential Assessment (ECA) report
Employment History Please provide your employment history the past 10 years, starting with your most current job.
Upload your resume *
What is your job NOC number (if known)?
For your work experience, can you provide a Certificate of Employment (COE)? * INADMISSIBILITY CHECK - Please read carefully Have you, or, if you are the principal applicant, any of your family members (spouse / common-law partner / conjugal partner, child/ren), ever:
Been convicted of a crime or offence in Canada for which a pardon has not been granted?
Been convicted of, or are you currently charged with, on trial for or party to a crime or offence, or subject to any criminal proceedings in any other country of territory?
Made previous claims for refugee protection in Canada or at a Canadian visa office abroad, in any other country(ies) or territory(ies), or with the United Nations Higher Commissioner for Refugees (UNHCR)?
Been refused refugee status, an immigrant or permanent resident visa (including a Certificat de selection du Quebec (CSQ) or application to the Provincial Nominee Program (PNP)) or visitor or temporary resident visa, to Canada or any other country of territory?
Been refused admission to, or ordered to leave, Canada or any other country or territory?
Been involved in an act of genocide, a war crime or in the commission of a crime against humanity?
Used, planned or advocated the use of armed struggle or violence to reach political, religious or social objectives?
Been associated with a group that used, uses, advocated or advocates the use of armed struggle or violence to reach political, religious or social objectives?
Been member of an organization that is or was engaged in an activity that is part of a pattern of criminal activity?
Been detained, incarcerated or put in jail?
Had any serious disease or physical or mental disorder?
If your answer to any of these questions is YES, provide details below: *
SPOUSE / COMMON-LAW PARTNER INFORMATION
Full Name
Date of Birth
Email address
Contact number
Country of birth
Country of residence if different from country of birth
If you are a citizen of more than one country, please list.
Have you taken an English language test?
Type of English test
Choose IELTS General IELTS Academic CELPIP General CELPIP Academic
Date of Test
Test results (Reading, Writing, Speaking, Listening)
Have you ever worked, studied or visited Canada?
If your answer is YES to the last question, what type of visa / permit were you granted for? Please provide more details as you can (inclusive dates of stay in Canada).
Level of Education Less than secondary school (high school) Secondary diploma (high school graduation) One-year degree, diploma or certificate from a university, college, trade or technical school, or other institute Two-year program at a university, college, trade or technical school, or other institute Bachelor's degree OR a three or more year program at a university, college, trade or technical school, or other institute Two or more certificates, diplomas, or degrees. One must be for a program of three or more years Master's degree, OR professional degree needed to practice in a licensed profession (For “professional degree,” the degree program must have been in: medicine, veterinary medicine, dentistry, optometry, law, chiropractic medicine, or pharmacy.) Doctoral level university degree (Ph.D.)
Other
Area of studies
EMPLOYMENT HISTORY: Please provide your employment history the past 10 years, starting with your most current job. Please list for each job: (1) company name, (2) position, (3) dates inclusive, (4) job location, (5) job responsibilities
Upload spouse resume
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