Client Information Form

Client Information Form
CAUTION: Please ensure that you have your RESUME/CV ready before you start. All applicable questions MUST be answered. You will be required to upload your resume and any other information relevant to your case at the end. Thank you.
Name*

First NameLast Name
E-mail*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
Date of birth*

MonthDayYear
Marital Status*

SingleCommon LawMarriedWidowedDivorced
Highest Education *

College DiplomaBachelor's DegreeMaster's DegreePhDOtherOther
What is the name of Institution that issued your certificate*
Date when certificate was issued*

MonthDayYear
Occupation*
Number of years work experience *
How many years CANADIAN WORK EXPERIENCE do you have? *
How much Savings do you have*

Over US$12500I have assets over US $50,000I have a valid job offer with an LMIA
How many children do you have*
Have you ever been charged or arrested?*
Have you or your spouse ever been refused a permit/ visa to Canada/ ordered to leave Canada of profile deemed ineligible?*
Have you sat an English exam for Immigration Purposes?*

YesNoSitting soon.
Did you get your credentials assessed? ( ECA) *

YesNoI applied for it.
Do you or your spouse have a Provincial Nominee Certificate *

YesNoI applied for it.
Name of Spouse
Date of Birth of spouse

MonthDayYear
Highest Education

College DiplomaBachelor's DegreeMaster's DegreePhDOther
What is the name of Institution that issued spouse certificate
Date when certificate was issued

MonthDayYear
Spouse Occupation
Number of years work experience
How may years CANADIAN WORK EXPERIENCE does your spouse have?
Did your spouse sit an English Exam for immigration purposes?
Has your spouse ever been charged with a criminal offence or arrested?
Resume *

Upload a File

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ID, Refusal letter, Spouse Resume, IELTS, ECA, LMIA, ITA or any other document relevant to your case

Upload a File

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By submitting this form you consent to Deidre S. Powell and her agents contacting you. You understand that your information will be kept confidential, however no Attorney/ Client privilege exists until a retainer agreement has been signed. Expect a response from us within 3 business days. If you do not hear from us please send an email to info@deidrepowell.com or call 613.695.8777.

Thank you.
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