Assessment Form

FAMILY MEMBERS TO MIGRATE
Principal applicant
How did you hear of us
   
Full name:
   
Address:
   
E-mail address:
   
Telephone number :
(Please indicate your evening/weekend telephone number, or the telephone number which is at the best time for us to speak with you in confidence) 
Please let us know how you would like to be contacted (email or telephone)
  
Date of birth (dd/mm/yy):
 
Place of birth:  
 
Town:
 State/Province:
 Country:
 
Present Country of Citizenship:
 
Marital status:
(ie. never married, married, widowed, separated, engaged, de-facto/common law)
 
Spouse (if applicable)
 
Full name:
 
Date of birth (dd/mm/yy):
 
Place of birth:
 
Town:
 State/Province:
 Country:
 
Present Country of Citizenship:
 
Marital status: 
(ie. never married, married, widowed, separated, engaged, de-facto/common law)
 
Dependents
(Please give details of all your and/or your spouse's children)
1st Child
 
Full name:
   
Date of birth (dd/mm/yy):
 
Place of birth:
 
Town:
 State/Province:
 Country:
 
Present Country of Citizenship:
 
2nd Child
 
Family name:
   
Date of birth (dd/mm/yy):
 
Place of birth:
 
Town:
 State/Province:
 Country:
 
Present Country of Citizenship:
 
3rd Child
 
Family name:
  
Date of birth (dd/mm/yy):
 
Place of birth:
 
Town:
 State/Province:
 Country:
 
Present Country of Citizenship:
 
EDUCATIONAL AND EMPLOYMENT DETAILS
Educational history of principal applicant
(Please list all post-secondary qualifications. Please number them 1, 2, etc)
 
Institution:
 		City and Country:
 
Date commenced:
 		Date completed:
 
Qualification attained:
 		Special skills:
 
Employment history of principal applicant
(Please include name and address of employer, dates of employment, your job title and brief description of duties)
 
Employment:
 		Employment:
 
Employment:
 		Employment:
 
Trade registrations and/or membership of professional associations:
 
Educational history of spouse 
(Please list all post-secondary qualifications. Please number them 1, 2, etc)
 
Institution:
 		City and Country:
 
Date commenced:
 		Date completed:
 
Qualification attained:
 		Special skills:
 
Employment history of spouse
(Please include name and address of employer, dates of employment, your job title and brief description of duties)
 
Employment:
 		Employment:
 
Employment:
 		Employment:
 
Trade registrations and/or membership of professional associations:
 
Settlement funds
(Please list your and your spouse's assets  -- please understand that this question is solely to determine if you are eligible for certain specific investment visas)
 
Transferable money:
 		Property:
 
Pension:
 		Other:
 
(Some governments grant residency / citizenship to individuals wishing to make a designated investme)
 
Please indicate if you would be willing to make such an investment to secure residency -
  YesNo
 
If yes, please indicate how much you would be willing to invest
 
 
Would you be willing to make a non-refundable investment.
 
Additional information
 (In this section you should indicate which countries you wish to relocate to, in order of preference. You may wish to provide any further information that may be relevant to your appraisal or you feel would assist you in your visa application, such as a CV.)
 

 
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