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Full
Name: Mr./Ms./Mrs. Date of
Birth:
Current
Mailing Address:
City:
Pin Code: State:
Country:
Phone:Fax:
Email:
Marital
Status (Never Married, Engaged, Married, Legally Separated,
Divorced):
If
you are married or engaged provide details of your spouse or
finance (e)
Full
Name: Mr./Ms./Mrs. Date of Birth:
Education:
Occupation:
Experience (No. Of Years):
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Provide
Details of all your children:
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Relative
in Canada if any: Please provide details of your relatives in
Canada, who are Permanent Residents/Citizens of Canada, (Describe
the relationship clearly such as father’s real brother,
mother’s sister etc.):
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Educational Record: Please provide
the Educational Record since matriculation with dates, names and
addresses of Institutions attended, courses taken (i.e Business
Administration, BE-Mechanical, Chemistry etc.), details of degree/
diploma/ certificate received. Include all full time and part time
courses:
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Work History: Please provide detailed
employment record with dates, names & addresses of employers
and job designations held:
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Experience in Business Management: In
this section tell us, in your own words about your past and
present business management experience. Please include details as
to how you started out, the type of nature of the businesses in
which you have being involved, giving specific details of your
responsibilities and duties within the company (ies). Specify your
percentage of ownership, if any. Should you require more space,
you may attach an additional page:
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Ability to communicate in English:
Fluent Well:
With Difficulty: Not At
All:
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Your current net worth (All assets
less liabilities)
Include all bank deposits,
property, estimated current market value of your share of business
and other assets. All assets must be your own personal holdings
and must be documented. You may be asked by the Canadian
Immigration Authorities o present financial documents to support
the information provided in this statement
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Have you ever visited abroad? If yes,
what all countries:
Dates: From:
To:
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For
which countries do you have valid visitors visas?
Have
you ever being refused tourist or any other visas? If yes, please
give details:
Have
you ever been deported from any countries? If yes, Please give
details:
How
did you come to know about CCICS
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I
declare that information given in this application is truthful,
complete and correct.
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Business
1:
Name
of Business: Type of Business:
You
may attach a complete business profile of your company along with
this application form.
Type
of ownership:
If
sole proprietorship, please also indicate date you became owner of
the business.
If
partnership: No. of partners
Your percentage (%) of ownership:
If
Limited Company:
No. of Directors: Your
Percentage of share holding:
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Performance:
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Business
2:
Name
of Business: Type of Business:
You
may attach a complete business profile of your company along with
this application form.
Type
of ownership:
If
sole proprietorship, please also indicate date you became owner of
the business.
If
partnership: No. of partners
Your percentage (%) of ownership:
If
Limited Company:
No. of Directors: Your
Percentage of share holding:
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Performance:
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Business
3:
Name
of Business: Type of Business:
You
may attach a complete business profile of your company along with
this application form.
Type
of ownership:
If
sole proprietorship, please also indicate date you became owner of
the business.
If
partnership: No. of partners
Your percentage (%) of ownership:
If
Limited Company:
No. of Directors: Your
Percentage of share holding:
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Performance:
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Business
4:
Name
of Business: Type of Business:
You
may attach a complete business profile of your company along with
this application form.
Type
of ownership:
If
sole proprietorship, please also indicate date you became owner of
the business.
If
partnership: No. of partners
Your percentage (%) of ownership:
If
Limited Company:
No. of Directors: Your
Percentage of share holding:
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Performance:
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By submitting this assessment form
you certify that the information you have provided is correct
to the best of your knowledge and it is for the purpose of
assessing you for applying for immigration to Canada
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