GENIQUE MANAGEMENT SERVICES PRIVATE LIMITED

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General Immigration
This form is for professionals and workers.

Business Immigration
This form is for individuals with management experience, or for business owners, having a high net worth.

Family Sponsorship
This form is for sponsorship of a Spouse/Common-Law Partner and/or Dependent Children.

FOR OFFICE USE

CONSULTANT NAME

COUNTRY FOR WHICH EVALUATION IS REQUESTED

SERVICE REQUESTED (PR / WP)

JOB ROLES CONFIRMED FOR (MENTION THE CODE)

RECEIPT No.

CLIENTS DOCUMENTS RECEIVED FOR THE EVALUATION

MARKSHEET

EDUCATION CERTIFICATE COPY

TE FORM

INFORM CLIENT REGARDING FUNDS REQUIREMENT

INFORM CLIENT REGARDING IELTS BAND REQUIRMENT &

WHAT BAND YOU HAVE EXPLAINED

FOR CANDIDATE USE

CANDIDATE’S NAME ( First Name + Last Name ) Itismita Dhal

DATE OF BIRTH 04/11/1998

CONTACT NUMBER 8249043079

EMAIL ID Itismitadhal1998@gmail.com

TOTAL EXPERIENCE (IN YEARS) 2 years

CURRENT CTC / SALARY PER ANNUM 3 Lakhs

FAMILY DETAILS

MARITAL STATUS Unmarried

GOING ALONE/ WITH SPOUSE Alone

INTIMATED FOR SPOUSE EMBASSY FEE (YES/NO) NA

SPOUSE QUALIFICATIONS NA

REGULAR /CORRESPONDENCE + Duration of course

NUMBER OF KIDS WITH AGE

RELATIVE IN COUNTRY

WHICH EVALUATION IS TAKEN PLACE

WHAT IS YOUR RELATION WITH THEM

EDUCATION DETAILS

PHD

Regular /Correspondence + Duration of Course + Passing year

MASTER DEGREE

Regular /Correspondence + Duration of Course + Passing year Regular + 2 years+ 2021

BACHELOR DEGREE
 Regular /Correspondence + Duration of Course + Passing year Regular + 3 years+ 2019

OTHER DIPLOMA OR CERTIFICATE

Regular /Correspondence + Duration of Course + Passing year PGDCA correspondence+ 6 month+ 2018

10th & 12th CLASS

Regular /Correspondence + Duration of Course + Passing year Regular + (1& 2) + (2014&2016)

EXPERIENCE DETAILS

TOTAL YEAR OF EXPERIENCE

Current Designation with duration + Period

Microbiology Technical + 6 months

Previous Employment Details

1. Designation + Period Microbiology Technical+ 1 year

2. Designation + Period Teaching Assistant + 6 momths

3. Designation + Period Intern + 6 months

4. Designation + Period

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The personal information you provide to the Genique Management Firm is secure and is collected with the sole purpose of assessing your
potential for immigration to the specified country under the current immigration selection criteria. We will respond to you only in regard to
your Immigration evaluation.