Consulting Request Form

Basic Information
First Name	Last Name
Gender	Date of Birth	(MM/DD/YYYY)
Citizenship	Marital Status
Number of Children	Relatives in Canada?

Contact Information
Home Phone	Cell	Fax
Email Address
Current Residential Address

Legal status in current residence

Expiry Date

(MM/DD/YYYY)

Work Experience for the past 10 year.
From(YYYY/MM)	To(YYYY/MM)	Position	City/Country	Name of Company or Employer





Can you support your work experience? (Proof of experience such as tax report)

The highest level of your education (e.g. Secondary, Trade/Apprenticeship, College Diploma/Degree, Bachelor's Degree, Master's Degree, Ph.D)
Education History
From(YYYY/MM)	To(YYYY/MM)	Name of Institution	City	Certificate/Diploma/Degree






List professional Certificates (if any)

English Fluency

French Fluency

Note

Payment Notice

Imin Consulting (Canada), Ltd. charges $350/USD per hour for an initial assessment. This fee covers in-depth consultation that is designed to help you develop a long-term immigration plan.

You can pay the fee by credit card/direct deposit/wire transfer. Our account number is 9400 - 5329215 (TD Canada Trust) , and after paying the fee, please notify us of your payment.

If you would like a credit card payment, please fill out the PDF form that we sent to you with the link and email it to visa@imin.ca or print and fax it to us at +1-604-608-9889.