Canada Immigration, Visa, Canadian Citizenship & Permanent Residence

Name: *

Email: *

Confirm Email: *

Phone: *

Sex:

Age: *

Country of Citizenship: *

Country of residence: *

State:

City: *

What is the highest education level obtained? (You can add more than one):

1. Certificate:

Field of Study:

Date Started:

Date of Graduation:

Name of Institution:

City:

Country:

Please provide all your employment history for the past 10 years, starting with the most recent:

1. Name of Company or Organization:

Job Title:

From:

To:

I currently work here

Employment Status:

Full Time

Part Time

Number of Hours Worked per Week:

Employment Duties:

City:

Country:

Are you the owner/CEO/partner?

Yes

What is your % of ownership?

How many employees are currently employed at your company?

Affiliation information

Why are you interested in pursuing an affiliation with Immigration.ca?

Do you have any specific background in immigration or related consulting?

Yes

If yes, please provide details:

Location preference:

Why does this location appeal to you?

Do you intend to devote full-time to the operation of this affiliation?

Yes

If no, please provide details about your reasons:

Have you previously been involved in an affiliation or operated any other franchise system?

Yes

If yes, please provide details (with whom, is the affiliation still ongoing, etc):

Are you willing to pay an upfront affiliation fee of USD $2,995? (No offsetting commission) *

Yes

Under our immigration.ca Affiliation Program, we charge an affiliation fee of USD $2,995. This gives our affiliates fully co-branded support with the leading global online immigration enterprise including: Affiliate landing page, email id under immigration.ca banner, brochure, business cards and full representation for all clients by licensed Canada immigration lawyers.

Additional Comments:

Have you (or any applicable partners, officers or primary shareholders) ever:

Been charged or convicted or pleaded guilty to any offence, in any court?

Yes

Had any involvement in a civil, arbitration, criminal or other legal action resulting in any judgement or sentence against you?

Yes

Been adjudged bankrupt or reorganized (as either an individual or as the owner of a principal officer of a business, company or corporation?)

Yes

If you answered yes to any of the questions above, please provide an explanation:

Immigration.ca welcomes strategic affiliations with international firms and qualified influencers
Grow your business by becoming an authorized Immigration.ca affiliated agent

Personal Information

Educational Profile

Employment History

Affiliation information

Other

Immigration.ca welcomes strategic affiliations with international firms and qualified influencers Grow your business by becoming an authorized Immigration.ca affiliated agent

Personal Information

Educational Profile

Employment History

Affiliation information

Other

Immigration.ca welcomes strategic affiliations with international firms and qualified influencers
Grow your business by becoming an authorized Immigration.ca affiliated agent