RICH GLOBAL TRAVELS

36a, Ladoke Akintola Road, Off Mr Biggs Junction, Favors, New Bodija, Ibadan, Oyo state
Email: richglobaltravels@gmail.com, Website:www.richglobaltravels.com
08033448292, 08149570501, 08172054000, 08172054001
Canada Immigration Assessment Form
SURNAME: ______________________________________ Prof/Dr/Mr/Mrs/Ms/Miss: ________________

Other Names: __________________________________________________________________________________

Date of Birth: ___________________________________ Native Language:____________________________

Your current Marital Status:

Never Married Married Widowed Legally Separated Divorced

Gender: ________________________ Country of Birth: _________________________________

Do you have International Passport: Yes No

Permanent Home Address: _________________________________________________________________

______________________________________________________________________________________________

_______________________________________________________________________________________________

Have you ever been refused a Canadian visa before: Yes No

If yes please give date and reason__________________________________________________________

____________________________________________________________________________________________

Telephone No: _______________________ __Alternative telephone No: _____________________________

Email address: __________________________________________________________________________________

Employment

What course did you study?_______________________________ Current Occupation:_______________________

How many years have you spent in your current occupation: _______________________________________

Employment History
Give details of all employment you have had in the last 10 years

From To Name of Employer Post Held

Year month Year Month
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 EDUCATION

Give the numbers of years you successfully completed for each of the following levels of education.

PRIMARY SCHOOL SECONDARY SCHOOL UNIVERSITY TRADE /APPRENTICESHIP

Give full details of all post secondary education ( university, polytechnic, college and apprenticeship training) you
have had.

From To Name of Institution Course studied Type of

Year month Year Month Certificates
issued e.g. OND,
HND, B.Sc, M.Sc

LANGUAGE

Which of this language can you speak? English French None

Have you taken International English Language Testing System (IELTS) exam (General Paper) Yes No

if yes what date did you take the English Exam____________________________

Which one did you take? General Academic

Test score: Speaking________ Reading_______ Writing_______ Listening_______

Your proficiency in English

No with Difficulty Well Fluent

SPEAKING

LISTENING

READING

WRITING

Your proficiency in French

No with Difficulty Well Fluent

SPEAKING

LISTENING
2

READING
Page

WRITING
 STUDY IN CANADA

Have you previously completed a program of full-time study of at least two years at a post-secondary institution in
Canada?

No Yes

WORK IN CANADA

Have you previously worked full-time in Canada?

No Yes

RELATIVES IN CANADA

Do you have a relative living in Canada who is a citizen or a permanent resident of Canada?

No Yes

Do you currently have an offer of employment from a Canadian employer? Yes No

If yes provide details below______________________________________________________________________

____________________________________________________________________________________________

Funds: How much in naira will you take with you as total savings when travelling to Canada?

a. < N3,000,000 b. N3,000,000 - N4,000,000 c. >N4,000,000

Please how did you get to know about us?____________________________________________________________________________

_____________________________________________________________________________________________________________

Disclaimer
The details you filled in this form will be used to assess your application for the Canadian migration program. It is the responsibility of all applicants to read
carefully and understand the requirements set out in the application forms, to complete all application forms truthfully, to provide correct and accurate information
and documentation, to ensure that they have a valid passport and all other personal documents needed for the application. You are responsible for the accuracy of
your application form and in checking your application form. We do not guarantee that we will find any errors, and we do not verify information you have
provided. The service charge, enrollment and assessment fees/application fees once received by Rich Global Travels (RGT) from the applicant will not be
refundable or transferable under any circumstances, irrespective of whether or not you are eligible or not. RGT in its sole discretion, may change, amend, cancel
or withdraw any or all of the terms and conditions mentioned herein at any time without any prior notice. Issuance and approval of a visa is solely regulated by the
embassy and governed by their rules and regulations that may be amended from time to time. RGT will file in the application subject to applicants fulfilling the
eligibility conditions. Should incase the Canadian Government make any new policy that may affect the conclusion of this business transaction, RGT cannot be
held liable for any delay or effect that may have on your visa processing. Canadian government have criteria's that are used to select people from all over the world
to come and live and work permanently in Canada. This assessment is the first step in determining your eligibility to migrate permanently to Canada. The total
amount payable and steps to be taken afterwards with other documentation required will be communicated to you with the result of the assessment. RGT will not
be held liable for your inability to provide all required documentations in a timely manner after the assessment or any other one requested thereafter, that may be
needed to compete the application.

I hereby accept and confirm that, prior to submitting this application, I have read, understood and agreed to be bound by, without limitation or qualification, all of
the terms, conditions and details provided herein. By signing the form or writing my name in the space allocated for name below (especially if filling the form
online) I accept that I have read and clearly understand all that is written and accept the terms and conditions stated herein

Name Signature Date

__________________________ ____________________________ ____________________
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