Shah Jamal - Visa & Immigration Consultant

Please print this form using your browser's print menu, fill-out and fax it to (1-718)523-4133

Page 1 of 3: Form WebPrint - Immigration Assessment - Shah Jamal

Shah Jamal
Visa, Immigration and Tax Consultant

87-40 165th St Apt 4J, Jamaica

NY 1432,USA;

Phone: 1-(718)-523-4123
Fax: 1-(718)-523-4133

Bangladesh Contact Office:

Visa & Com World
PRABASH,KHA-71/4/A,

TanPara,(Nikunja-2)Khilkhet,

Dhaka-1229,Bangladesh;

Phone: 880-2-8922089
Fax: 880-2-8922089
E-mail: info@shahjamal.com

shahjamal@yahoo.com

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IMMIGRATION PREQUALIFICATION ASSESSMENT

PRINTING INSTRUCTION: Best if print using left & right margins at 0.11". This Form WebPrint page contain two page Assessment Form and one page instruction for those who do not feel WebFillOutForm convenient to fill out. It is in HTML format, so you can print it directly using our Browser program, i.e., it need no special program like Acrobat.

Form Preparation Instruction: .Print 3 original pages and fill out all 28 items including separate duties and responsibilities. When completed, fax it to (880-2)8824723 or send by mail or courier. If you think your wife/husband have any professional qualification and experience, please also use another set of this form for his/her as well. No-cost is only for email response from me to your own email account/address, otherwise not free. Please read below info for charges of non-email answer before sending the fax.

INTENDING APPLICANTS FOR IMMIGRATION TO CANADA/AUSTRALIA/ NEW ZEALAND. FREE ASSESSMENT FOR DIRECT APPLICANTS ONLY IF HAVE OWN EMAIL; NOT FREE IF I GET ASSESSMENT REQUEST THROUGH ANY THIRD PERSON, OR AGENT, IN THAT CASE A MINIMUM CHARGE OF TK.500 PER CASE NEED TO BE PAID FIRST, OTHERWISE I WILL NOT BE ABLE TO KNOW YOU MY FINDING YES/NO RESULT. Direct applicants having no email can use HTML print form or its photocopy but need to pay advance Tk. 200 for registration/handling costs to get assessment result through regular mail. For confidentiality, no over-phone assessment result. Answer to all 28 blocks, DON’T skip any question. Incomplete form will not be assessed, I will never call you for missing data, it is your responsibility to re-check any incomplete block. Use extra sheets if needed. All data entered here should be accurate per documentary evidence. Tick appropriate one or write N/A if inapplicable. Recheck latest regulations before formal application submission, if not submit immediately. This Free Assessment does not constitute any client-consultant relationship. This is not a guaranty or acceptance. Do not quit your job, sell or give away your possessions until you have been issued an immigration visa. I’m not bound to disclose details of my assessment findings or calculation points, you will just know positive or negative only. Don’t attach your original document, documents submitted are not returnable, be careful. If assessed ok, you are free to apply own; if want our service, our total processing fee is a fraction of other foreign lawyers/consultants visiting Dhaka. You need only to sign, provide us certificates etc, and money, we will do everything till visa issue. You may need to attend for interview and MUST need medical exam. Most recent version of all forms readily available with us. Shah Jamal December 24, 2003.
End of instruction, page 1 of 3.

...Contd p2

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Page 2 of 3:Form WebPrint - Immigration Assessment - Shah Jamal

1. Full name as in school certificate:

2. Father’s fname:

3. Mother’s name:

4. Your name in native language:

5. Birth date (as in ssc)

dd/mm/yy

6. Birth place & citizenship:

7. Circle document numbers you have in hand, attach 1 extra copy only when asked for: (1) self passport (2) passports of all including dependent husband/wife; (3) self birth certificates; (4) birth certificates of all dependents:, (4) marriage/divorce certificate; ( 5) experience certificates all (6) earlier experiience certificates only; (7) educational certificates; (8) marksheets; (9) certified eng translations, all non-eng doc. (10) ccpe / cctt communication; (11) professional association membership; (12) police clearance from foreign countries if any of you resided more than 6 months after age 18.

8. Age today(exact)

day/ month/ year

9. Home / permanent residential address::

Phone: ____________________fax: ____________________ email:___________________________

10. Your current/ mailing address:

[ ] same as in question 9.

Phone: ____________________ fax:____________

11.present marital status (check more than one as applicable):

Never married [ ] married [ ] widowed [ ] separated [ ] divorced [ ] married earlier once [ ]

12. Short name & age of all children

13. Date and place of marriage

15. Full name, date & place of birth of your husband/wife:

16. Highest degree of your wife/husband & occupation

17. Your total experience in each designation

___ years____ months as __________

18.total year s of education

14. Citizenship of wife/husband:

____years ____months as ________

____years ____months as_________

___________years

19. Lang: score #

Ability in english (TOEFL/IELTS/ACCESS score:_________)

Ability in french

______speak:

Fluently: [ ]

Well: [ ]

with difficulty: [ ]

Not at all: [ ]

Fluently: [ ]

Well: [ ]

with difficulty: [ ]

Not at all: [ ]

________read:

Fluently: [ ]

Well: [ ]

with difficulty: [ ]

Not at all: [ ]

Fluently: [ ]

Well: [ ]

with difficulty: [ ]

Not at all: [ ]

________write:

Fluently: [ ]

Well: [ ]

with difficulty: [ ]

Not at all: [ ]

Fluently: [ ]

Well: [ ]

with difficulty: [ ]

Not at all: [ ]

_______understand:

Fluently : [ ]

Well: [ ]

with difficulty: [ ]

Not at all: [ ]

Fluently: [ ]

Well: [ ]

with difficulty: [ ]

Not at all: [ ]

20. Details of your all after ssc educations & trainings, workshop s, language trng , on-the-job trng , etc. (use overleaf /continue in a blank sheet if needed)

dates attended (month/year) From --------------------- To	Name of institution (board / university within parenthesis), mailing address (including apprenticeship trng, & all short trngs with details & dates start to end (specify if not full-time study, i.e., Evening /private, abnormal delay in class/exam held/result declaration)	All major subjects of study Or course contents	Degree/course title & pass date




21. Your present occupation (write exact official designation, business type, your duties & responsibilities, gross monthly salary )		22. Have you or has anyone of your dependent ever:(a) been convicted of or currently charged with any crime or offense in any country? (b). Had any serious disease or mental disorder? (c) applied previously for a visa for canada/australia/nz? (d). Any visa refusal/deportation by foreign mission? Give details, in separate sheet. E. Have resided in countries for over six months at a time after age 18? Name of all countries? When? Write details of any yes above in separate sheet.
23. All your experience after secondary(a paragraph on duties & responsibilities of each position in attached sheet. Don’t skip a month, note if unemployed over 30 days) *
Experience dates (month/year) From -------------------To	Name of employer, with mail address—if self employed your own/firm name, (write name in full, do not use abbreviations)( list all chronologically with specific start and end dates--no estimate—duty list of all must attached in separate)	Employer’s function/type Or dept/division//branch/products	Designation, exact (weekly duty hrs)




24. Name, relationship & address of close relative in canada/australia/new zealand who are permanent residents or citizens. Write relationship with you and duration of his/her immigrant status there (as citizen and/or immigrant)		25. Be able to go visa office abroad with adult dependent for interview, if needed?
		26. Will your full family apply with you or later?
		27. Transferable money in can$.	28. Value of other property in c$

Re-check exact dates & duty-lists in 17,20, 21&23. Any mistake/missing? Correct/complete all blocks, otherwise will delay assessment result.

Applicant’s Signature:_____________________________ Date:___________________

End of Page 2:
Page 3 of 3:Form WebPrint - Immigration Assessment - Shah Jamal

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DETAILS OF DUTIES AND RESPONSIBILITIES AS IN BLOCK 23:

1. (List most current experience first)

Date (month/Year)____/____ To____/____ Official Designation:_______________________

Short details of duties & responsibilities (list at least 7 to 10 items):

____________________________________________________________________________

2. (Immediate previous experience)

Date (month/Year)____/____ To____/____ Official Designation:_____________________

Short details of duties & responsibilities (list at least 7 to 10 items):

____________________________________________________________________________

3. (Previous experience)

Date (month/Year) ____/___ To____/____ Official Designation:________________________

Short details of duties & responsibilities (list at least 7 to 10 items):

____________________________________________________________________________

4. (Previous experience)

Date (month/Year)____/____ To____/____ Official Designation:_______________________

Short details of duties & responsibilities (list at least 7 to 10 items):

____________________________________________________________________________

Signature:_________________ Date: ___________ Your own Email:_________________

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