STUDENT VISA

Student Visa

CONTACT INFORMATION

Salutation(Required)

Name(Required)

First Middle Last

Mailing Address(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

Email(Required)

Phone(Required)

WhatsApp/Viber/IMO Number(Required)

AGE, FAMILY & NATIONALITY

Date of Birth(Required)

Current Age(Required)

Nationality(Required)

Country of Residence(Required)

Civil Status(Required)

Single

Married

Divorced

Dual Nationality?(Required)

Yes

Country of Dual Nationality

Do You Have Any Dependent Children?

Yes

Please add their information below:

Name

Age

Gender

Date of Birth (DD/MM/YYYY)

Place of Birth (City, Country)

Do you have children over 22 years of age with a physical or mental disability?

Yes

Please provide details below:

EDUCATIONAL QUALIFICATION

Have you completed Grade 10 (Secondary School/GCE Ordinary Level)?(Required)

Yes

Please provide details below:(Required)

Medium of Instruction

Name of Educational Institution

Country

Year Graduated/Completed

Please provide the results of your Grade 10 (Secondary School/GCE Ordinary Level)(Required)

Use the “+” button to add a line for each subject.

Subject

Grade

Have you completed Grade 12 (High School/GCE Advanced Level)?(Required)

Yes

Please provide details below:(Required)

Medium of Instruction

Name of Educational Institution

Country

Year Graduated/Completed

Please Provide The Results of your Grade 12 exam (High School/GCE Advanced Level)(Required)

Use the “+” button to add a line for each subject.

Subject

Grade

Have you completed any Education/Training after High School (Secondary/GCE A/L)?(Required)

Yes

Please provide details below:(Required)

Degree/Diploma

Field of Study

College/University

City

Country

On-campus/Distant?

Start Month & Year

End Month & Year

EMPLOYMENT

Have you had any paid employment before/after graduation?(Required)

Yes

Please provide details of your employment below:

Click the “+” button to add more rows for additional employment details.

Position/Job Title

Employer

Work Hours per Week

City

Country

Monthly Salary (in CAD)

Start Month & Year

End Month & Year

LANGUAGE PROFICIENCY

Please choose the value that best describes your English & French language proficiency:

English Language Proficiency

Speaking(Required)

Listening(Required)

Reading(Required)

Writing(Required)

French Language Proficiency

Speaking

Listening

Reading

Writing

Have you taken any formal language tests such as IELTS, CELPIP, or TEF?(Required)

Yes

Please provide details (including test scores) below:

Please enter in chronological order with the most recent tests on top. You can use the ‘+’ button at the end to add more tests.

Name of the Test

General/Academic

Date Taken

Speaking Score

Listening Score

Reading Score

Writing Score

HIGHER STUDIES IN CANADA

What program credentials do you intend to pursue in Canada?(Required)

Certificate

Diploma

Bachelor’s Degree

Master’s Degree

PhD Program

As you have selected a Certificate/Diploma above, how many years should the program duration be?

1 Year

2 Years

3 Years

Do you prefer to have “Work-Integrated Learning” included in the program?

In some programs, real life work experience is part of the curriculum. It is known as Co-op/Internship where students get hands-on experience in their fields of study with employers and industry partners.

Yes; should be mandatory

Yes; optional

Do you like to complete your program in Fast Track?

In Fast Track programs, student can complete a 3-year course in 2 years. However, the course fee will be for all 3 years of program content.

Yes

Not sure; tell me more

Select 3 Canadian provinces where you prefer to study?(Required)

Do you have preferences for any colleges/universities in the provinces you selected above?

Yes

Please specify upto 3 institutions of your choice below:

Click the “+” button to add more rows for additional institutions.

Select the field/s of study you would like to pursue in Canada?(Required)

The below is not an exhaustive list. Please search the internet for a complete list of programs offered by each university or college in Canada. These links would be useful to get a general overview:
https://www.senecacollege.ca/programs/byareaofstudy.html
https://www.ryerson.ca/graduate/programs/

Since you have selected "Other", please specify 3 program choices that are not listed above.

Click the “+” button to add more rows for additional programs.

When would you like to start?(Required)

Fall Semester (September)

Winter Semester (January)

Summer Semester (May)

SPOUSAL DETAILS

Will your spouse accompany you to Canada?

Yes

Please Provide Spouse Details Below

Specify Relationship Category

Spouse

Common Law Partner

Conjugal Partner

Spouse Name

First Middle Last

Date of Birth

Place of Birth

City Country

Nationality

Country of Residence

Dual Nationality?

Yes

Country of Dual Nationality

Spouse’ Education

Has your spouse completed High School (Secondary School/GCE Advanced level)?

Yes

Has your spouse completed any Education/Training after High School (Secondary/GCE A/L)?

Yes

Please provide their higher educational details below:

Use the “+” to add more rows.

Degree/Diploma

Field of Study

College/University

City

Country

On-campus/Distant?

Start Month & Year

End Month & Year

Spouse’ Employment

Has your spouse ever had paid employment in the last 10 years?

Yes

Please provide their employment details below:

Use the “+” to add more rows.

Position/Job Title

Employer

Full Time/Part Time

City

Country

Monthly Salary (in CAD)

Start Month & Year

End Month & Year

CANADIAN CONNECTIONS

Have you ever travelled to Canada before?(Required)

Yes

Please Provide Details

Purpose of Travel

Places Visited in Canada

Duration of Visit

Year of Visit

Do you/your spouse have family members or close friends living in Canada?(Required)

Yes

Please provide details of the family member/friend below:

Use the “+” button to add rows.

Relationship to You

Their Immigration Status in Canada

Their Province of Residence

LIFE DURING & AFTER STUDIES

How do you plan to finance your studies in Canada?(Required)

Select all that apply.

Scholarship from Canada

Scholarship from International Organization

Self-funded

Scholarship from home/foreign country

Funding by friends/family/relatives

Part-Time work during study period

How much do you intend to pay annually in CANADIAN dollars as university fees?(Required)

Where do you intend to stay while studying in Canada?(Required)

With family/friends/relatives

In college/university residence

In a private rental home/apartment

Other

What do you intend to do after completing your studies?(Required)

Pursuing further studies in Canada

Securing a job in Canada

Applying for Permanent Residency

Returning back to my Country of Origin

Please provide more details:

SECURITY & HEALTH

Have you ever been denied visa/entry to any foreign country?(Required)

Yes

Please provide details below:

Have you ever claimed refugee status in any foreign country?(Required)

Yes

Please provide details below:

Have you ever been deported from any foreign country?(Required)

Yes

Please provide details below:

Have you ever been convicted of a criminal offense either in your home country or a foreign country?(Required)

Yes

Please provide details below:

BRIEF SURVEY

How did you come to know about Zimmr Immigration Consultancy firm?(Required)

Seminar

Internet Search

Newspaper

Social Media

Family/Friend

Other

Please mention the name of the person who referred you:

How would you rate your knowledge about Canada, its culture, people, and its Education System?(Required)

Excellent

Good

Fair

Poor

How would you rate completing this assessment form?(Required)

Easy

Moderate

Difficult

How did you come to know about our immigration consultancy firm?(Required)

Google Search

Social Media Ad

WhatsApp/Viber/IMO

Newspaper Ad

Friend/Relative

Agent

Select Social Media Channel

Facebook

Instagram

Twitter

Name of the Friend/Relative who referred us to you:

Name of the Agent who referred us to you:

Country of Residence of the Agent:

Today's Date

Signature

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