SOMJEN & PETERSON
Barristers and Solicitors
1240 BAY STREET, SUITE 810 • TORONTO, ONTARIO, CANADA M5R 2A7 • TEL: (416) 922-8083 FAX: (416) 922-4234
FULL NAME
Last Name
First Name & Middle Name
DATE OF BIRTH
Female
Male
D/M/Y
MARITAL STATUS
Married
Never Married
Divorced
Widowed
Separated
Living with partner for at least one year
CITIZENSHIP
E-MAIL ADDRESS
POSTAL ADDRESS
Street Address
Postal Code
City
Country
(telephone -- home)
(telephone -- work)
EDUCATION (Including Formal Apprenticeship Training)
Dates
Name of University/Technical School
Type of Diploma
From/To
/
/
/
ENTIRE WORK HISTORY
Dates
Name of Employer
City/Country
Job Title
From/To
/
/
/
/
/
ABILITY IN ENGLISH
FLUENT
MODERATE
BASIC
NONE
Speak
Read
Write
Listen
ABILITY IN FRENCH
FLUENT
MODERATE
BASIC
NONE
Speak
Read
Write
Listen
DO YOU HAVE ANY RELATIVES WHO ARE LEGALLY RESIDENT IN CANADA?
Yes
No
If yes, state relationship (mother, father, brother, sister, aunt, uncle, etc)
INFORMATION CONCERNING YOUR SPOUSE/PARTNER
Name:
Date of birth:
Highest level of Education:
Occupation:
INFORMATION ABOUT YOUR CHILDREN
Number of Children:
Ages:
Additional Facts you want to give us concerning your situation:
For example,
a) your net assets valued in US Dollar terms;
b) have you ever owned a business - give details;
c) do you have personal contacts in Canada who can arrange a job offer for you.
We will reply to you within 5 days if your case is viable.
*
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