General Questionnaire

PERSONAL DETAILS

You Spouse Dependent Children

Mr. / Ms. / Mrs.
Family or Surname

First Name

Date of Birth

Place of Birth
City/ Country
Marital Status

Citizenship(s)

Country of Residence

Status in country of
Residence
Permanent Address

Telephone

Email

I wish to:

Immigrate to Work in Canada Study in Canada Invest in Canada Other

Canada please specify below

EDUCATIONAL BACKGROUND (You)

4646 Dufferin Street, Suite 6, Toronto, ON M3H 5S4, Canada

Tel: +1(416) 649-7727 Fax: +1(416) 649-7725 Email: info@vbimmigration.com
Please list all Post Secondary education obtained including degree, certificates, diplomas
and apprenticeships

Name of College/ Education obtained From To City/ Country

University (mm/yyyy) (mm/yyyy)

EDUCATIONAL BACKGROUND (Spouse – if applicable)

Name of College/ Education Obtained From To City/ Country

University/ (mm/yyyy) (mm/yyyy)

EMPLOYMENT BACKGROUND (You)

Name of Employer Position Held From To City/ Country

(mm/yyyy) (mm/yyyy)

4646 Dufferin Street, Suite 6, Toronto, ON M3H 5S4, Canada

Tel: +1(416) 649-7727 Fax: +1(416) 649-7725 Email: info@vbimmigration.com
EMPLOYMENT BACKGROUND (Spouse – if applicable)

Name of Employer Position Held From To City/ Country

(mm/yyyy) (mm/yyyy)

LANGUAGE ABILITY - ENGLISH

Listening Skills Speaking Skills Reading Skills Writing Skills

You - Fluent
Fluent
(select or underline) - Adequate
Adequate
Weak
- Weak
None
- None
Spouse
(select or underline)

If YOU have taken IELTS or any other English proficiency exams, please indicate the date the test was taken
and your score in each module:

Date Exam Type Listening Speaking Reading Writing

If YOUR SPOUSE has taken IELTS or any other English proficiency exams, please indicate the date the test
was taken and your score in each module:

Date Exam Type Listening Speaking Reading Writing

4646 Dufferin Street, Suite 6, Toronto, ON M3H 5S4, Canada

Tel: +1(416) 649-7727 Fax: +1(416) 649-7725 Email: info@vbimmigration.com
 CAPACITÉ LINGUISTIQUE – FRANÇAIS

Capacité d'écoute Talents d'orateur Compétences en Compétences en

lecture écriture
Toi - Courant - Courant - Courant - Courant
(sélectionner ou souligner) - Adéquat - Adéquat - Adéquat - Adéquat
- Faible - Faible - Faible - Faible
- None - None - None - None
Époux - Courant - Courant - Courant - Courant
(sélectionner ou souligner) - Adéquat - Adéquat - Adéquat - Adéquat
- Faible - Faible - Faible - Faible
- None - None - None - None

CAPACITÉ LINGUISTIQUE - FRANÇAIS

Si vous avez déjà passé des examens TEF ou TEFaQ, veuillez indiquer la date à laquelle le test a été effectué
et votre score dans chaque groupe:

Date A1 à B1 B2 C1 à C2
Comprehénsion orale

Expression orale

Comprehénsion écrite

Expression écrite

Si votre conjoint a passé les examens TEF ou TEFaQ, veuillez indiquer la date à laquelle le test a été passé et
son score dans chaque groupe:

Date A1 à B1 B2 C1 à C2
Comprehénsion orale

Expression orale

Comprehénsion écrite

Expression écrite

4646 Dufferin Street, Suite 6, Toronto, ON M3H 5S4, Canada

Tel: +1(416) 649-7727 Fax: +1(416) 649-7725 Email: info@vbimmigration.com
FAMILY LIVING IN CANADA
Do you or your spouse (if applicable) have any direct relatives living in Canada? (i.e., Parents,
grandparents, children, brother/sister, uncle/aunt) If YES, please provide their information below:

Name Relationship City/ Province Status in Is the relative

Canada sponsoring you?
(Yes/No)

FINANCIAL INFORMATION (optional)

Please provide the following information in U.S. dollars:

You Spouse Dependent Children

a. Liquid Assets

b. Value of property

c. Value of other assets

(e.g. stocks, investments)

Total Net worth

TRAVEL HISTORY:

Have you or your accompanying dependents traveled outside the country of your permanent residence/
nationality? If yes, list details. If additional space needed, please continue at the end of the questionnaire:

From To Purpose of travel City/ Country Reason of overstay (if

mm/dd/yyyy mm/dd/yyyy applicable)

4646 Dufferin Street, Suite 6, Toronto, ON M3H 5S4, Canada

Tel: +1(416) 649-7727 Fax: +1(416) 649-7725 Email: info@vbimmigration.com
GENERAL QUESTIONS:

Have you or your accompanying dependents ever (Underline/Bold your answer):

Had any serious disease or physical or mental disorder? (Yes)(No)

Been convicted of or are currently charged with any crime or offence in any country? (Yes)
(No) Applied previously for immigrant or visitor/student/worker visa of Canada? (Yes)(No)
Been refused an immigrant or visitor visa to Canada or any other country? (Yes)(No)
Been refused admission to, or ordered to leave Canada or any other country? (Yes)(No)
Been involved in the commission of a war crime or a crime against humanity? (Yes)(No)
Applied previously for permanent status in Canada? (Yes)(No)
If you have answered "Yes" to any of the questions, please provide details below:

If you have any general questions or concerns, please list them below:

How did you hear about us?

GOOGLE Social Media Newspaper Ad Recommended by Other/ returning

Friend client

4646 Dufferin Street, Suite 6, Toronto, ON M3H 5S4, Canada

Tel: +1(416) 649-7727 Fax: +1(416) 649-7725 Email: info@vbimmigration.com
 FOR OFFICE USE ONLY

Questionnaire received on: Client’s CRS (if applicable)

Remarks:

Book Initial consultation for (mm/dd/yyyy) Initial Consultation Retainer and fee status
Received  Pending 

Associate name: Retainer Agreement sent on Next follow-up on

4646 Dufferin Street, Suite 6, Toronto, ON M3H 5S4, Canada

Tel: +1(416) 649-7727 Fax: +1(416) 649-7725 Email: info@vbimmigration.com