Information Request Form - Simplified

Potential Client Information Form

To proceed, we kindly request you to provide your information and grant consent for the use of your personal data.

Last name

Phone

Select an Address

Work experience: Position

Intension to Live: Canadian City

Any medical issue (No or Details)?

First name

Birthday

Net worth

Major

Work experience: Full-time Years

Intension to Work: Position

Any visa refusal (No or Details)?

Any millitary record (No or Details)?

Any criminal record (No or Details)?

This information collectin shall be governed by the laws in effect in the Province/Territory of British Columbia, and the federal laws of Canada applicable therein. Please be advised that Daniel Shin is a member in good standing of the Immigration College of Canadian Immigration Consultant (CCIC), and as such, is bound by its Bylaw, Code of Professional Ethics, and Regulations.

I hereby consent to the use of my information for the purpose of reviewing my case.

Submission Done! - Potential Client Information Form