INFO COLLECTION FORM

Technical Evaluation ICF2 Country (CAN / AUS /NZ/Quebec)

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Accompanying Dependents
Will your spouse accompany you to Aus/New Zealand/Canada/Quebec? Will your children accompany you to New Zealand/Aus/Canada/Quebec? Yes Yes No No

Any relatives in New Zealand/Canada/Australia

Describe relationship Country Relative of Visa Status Relatives Residing Address (With Province and Postal Code) : Own Brother Example: Fathers

(Do not define it as Paternal Uncle) : Self Spouse : (Student Visa / Work Permit / Provisional Visa / PR / Citizen) :

Overseas Study / Work History

Had you traveled to New Zealand/Canada/Australia/Quebec for work/visit If yes please mention the dates Do you or spouse have a job offer or current employment from New Zealand/Canada/Australia/ Quebec If yes please mention the details of employment (occupation) and the duration Have you traveled to the European Union in the past 5 yrs If yes please mention the purpose and dates Have you traveled to any other country in the last 10 years for a stay more than 1 yr including the all the short durations If yes please mention the country/ purpose and dates : Yes : Yes : No No Yes : Yes No No

Fulltime studies in Canada / Australia / New Zealand

Name of the Country/Province Name of the Course Name of the University Duration of Study : NIL : : :

Work experience in Canada / Australia / New Zealand

Y AXIS Overseas Careers

Name of the Country/Province Name of the Company Designation Duration of Employment

: NIL : : :

Previous Application and Rejections (Self)

Have you ever been refused a visa for any country? If yes what type of visa and for which country? What type of visa application? What is reason for refusal? Did you lodge an application under Canada PR FSW? If yes, what is the date of application? Occupation nominated as per Canada NOC list? Status of your Canada PR application: Yes No : : : NIL : : : Success

Rejection

In progress

Previous Application and Rejections (Spouse)

Has your spouse ever been refused a visa for any country? If yes what type of visa and for which country? What type of visa application? What is reason for refusal? Did you lodge an application under Canada PR FSW? If yes, what is the date of application? Occupation nominated as per Canada NOC list? Status of your Canada PR application: : : : NIL : : : Success Rejection In progress

Yes

No

Tax Returns
Did you file income tax returns in the recent last 3 years? If Yes, please furnish the details of which year(s) you filed Income Tax Returns and also let us know about your IT if filed in overseas Yes : No

Y AXIS Overseas Careers

COUNSELORS NOTES
(To be filled in by the Counselor for office use )
Specify the Recommended Occupation from the SOL or Positive list (refer to SOL or Positive list and mention the suitable title) Has the client agreed with the job description as specified in the NOC / ASCO booklets for the recommended occupation?
Yes No

Specify the duration of the SOL / ANZSCO experience: From (MM/YY): To (MM/YY):

Y AXIS Overseas Careers