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ICC Canada Immigration Solutions Inc

Student Visa Information Form India, Pakistan, UK, and Australia


Information Of Principal Applicant (Student) Please put N/A which is not applicable to you.
Surname(As Per Passport
Given Name(As Per Passport
Any Other Names You Have Been Using
Gender ( Please Select One)
Passport Number
Country Of Issue
Passport
Details
Date Of Expiry
Date of Issue

Male

Female

Address
Address
Address
City
Country

State
Postal code

Date Of Birth(As Per Passport)


Day

Month

Myself

Parents

Year

Home Phone Number


Cell Phone Number
Email Id
Place Of Birth(As Per Passport)
Country Of Birth
Citizenship
Current Country Of Residence
Status In Country Of Residence
Native Language
Current Occupation
Funds-Available In Bank/Cash/ or Bank Loan
Who will be supporting you financially for your
studies? If you select other please provide details
Married Or Unmarried

If Yes Then Date Of


Marriage

Yes
No
Can You Communicate In English
Can You Communicate In French

Day

Other

Month

Year

Yes
Yes

No
No

Educational Details -Please put N/A which is not applicable to you.


Masters

Bachelors

Grade 12
/Secondary

Grade 10 /
Higher
Secondary

Diploma/
Certificate

Name Of
Institution
Major
Subject
Date From
Month/Year
Date To
Month/Year
Education
Term

Regular

Private

Regular

Private

Regular

Private

Regular

Private

Regular

Private

City
Country
Designed By: Rohit | Page 1 of 11

ICC Canada Immigration Solutions Inc


Professional Membership (If Applicable, Please provide details)
Membership 1

Membership 2

Membership 3

Membership4

Name of
Professional
Membership
City,
Country
Duration

Days

Months

Days

Months

Days

Months

Days

Months

Any Military Services (If Applicable, Please provide details)


Military Services 1

Military Services 2

Military Services 3

Military Services 4

Branch
City,
Country
Duration

Days

Months

Days

Months

Days

Months

Days

Months

Any Government Services (If Applicable, Please provide details)


Government
Services 1

Government
Services 2

Government
Services 3

Government
Services 4

Branch
City,
Country
Duration

Days

Months

Days

Months

Days

Months

Days

Months

Previous Visa Applications ( If Applicable)


Have You Previously Applied For Permanent Resident Visa, Temporary Resident Visa, or ever been
sponsored or included in a permanent residence application for Canada?
If yes give details
Visit 1
Visit 2
Visit 3
Date of Entry
Date of Departure
Reason of leaving

Yes

No

Visit 4

Other comments related to visits and permanent residence applications

Designed By: Rohit | Page 2 of 11

ICC Canada Immigration Solutions Inc


Blood Relation In Canada (If Applicable) Please put N/A which is not applicable to you.
Any Blood Relation In Canada Who Are Citizen Or
Permanent Resident
Relative 1

Yes

(If Yes Then Pleas Give Following


Details:-

No

Relative 2

Relative 3

Relative 4

Name
Relation

Present Address

Status of Relative

PR

Citizen

PR

Citizen

PR

Citizen

PR

Citizen

Work History Till Date-For Past Ten Years (If Applicable) Please put N/A which is not applicable to you.
Company 1

Company 2

Company 3

Company 4

Company 5

Name of
Company
Designation
Date From
Month/Year
Date To
Month/Year
Salary
City
Country
Family Details Father and Mother
Father

Mother

Family Name
Given Name
Date Of Birth
Place Of Birth
Marital Status
Present Address
City
State/Province
Country
Postal Code
Date Of Death
(If Deceased)

Occupation

Designed By: Rohit | Page 3 of 11

ICC Canada Immigration Solutions Inc


Work History Till Date-For Past Ten Years (If Applicable) of Father or Mother on whose income you are
dependent - Please put N/A which is not applicable to you.
Company 1

Company 2

Company 3

Company 4

Company 5

Name of
Company
Designation
Date From
Month/Year
Date To
Month/Year
Salary
City
Country
Family Details - Brothers (If Applicable) Please put N/A which is not applicable to you.
Brother 1

Brother 2

Brother 3

Brother 4

Family Name
Given Name
Date of Birth
Place of Birth
Marital Status
Occupation
Date Of Death
(If Deceased)

Present Address
City
Postal Code
Province /State
Country
Family Details - Sisters (If Applicable) Please put N/A which is not applicable to you.
Sister 1

Sister 2

Sister 3

Sister 4

Family Name
Given Name
Date of Birth
Place of Birth
Marital Status
Occupation
Designed By: Rohit | Page 4 of 11

ICC Canada Immigration Solutions Inc


Date Of Death
(If Deceased)

Present Address
City
Postal Code
Province /State
Country
Children Information (If Applicable) Please put N/A which is not applicable to you.
Child 1

Child 2

Child 3

Child 4

Name
Family Name (As
Per Passport)
Given Name (As
Per Passport)
Passport Number
Country Of Issue
Present Country Of
Residence
Passport Expiry
Date
Passport Issuance
Date
Date Of Birth
Place Of Birth
Height

Ft

In

Ft

In

Ft

In

Ft

In

Son

Daughter

Son

Daughter

Son

Daughter

Son

Daughter

Color of Eye
Relation
Number Of Years
Of Education
Can Communicate
In English Or Not
Id Card Number (If
Applicable)

Yes

No

Yes

No

Yes

No

Yes

No

Marital Status
Present Address
City
Postal Code
Province /State
Country

Designed By: Rohit | Page 5 of 11

ICC Canada Immigration Solutions Inc


Information Of Spouse (In Case Of Married Applicant) Please put N/A which is not applicable to you.
Surname(As Per Passport
Given Name(As Per Passport
Any Other Names You Have Been Using
Gender ( Please Select One)
Passport Number
Passport Details
Country Of Issue
Date Of Expiry

Male

Female

Date Of Birth(As Per Passport)


Day
Contact Number
Email Id
Place Of Birth(As Per Passport)
Country Of Birth
Citizenship
Current Country Of Residence
Status In Country Of Residence
Native Language
Current Occupation
Can You Communicate In English
Can You Communicate In French

Month

Yes
Yes

Year

No
No

Educational Details of Spouse (If Applicable) Please put N/A which is not applicable to you.
Education Info 1

Education Info 2

Education Info 3

Education Info 4

Education Info 5

Regular

Regular

Regular

Regular

Regular

Name Of
Institution
Major
Subject
Date From
Month /Year
Date To
Month/Year
Education
Term

Private

Private

Private

Private

Private

City
Country
Other comments related to spouse study

Designed By: Rohit | Page 6 of 11

ICC Canada Immigration Solutions Inc


Professional Memberships of Spouse (If Applicable, Please provide details)
Membership 1

Membership 2

Membership 3

Membership4

Name of
Professional
Membership
City,
Country
Duration

Days

Months

Days

Months

Days

Months

Days

Months

Any Military Services of Spouse (If Applicable, Please provide details)


Military Services 1

Military Services 2

Military Services 3

Military Services 4

Branch
City,
Country
Duration

Days

Months

Days

Months

Days

Months

Days

Months

Any Government Services of Spouse (If Applicable, Please provide details)


Government
Services 1

Government
Services 2

Government
Services 3

Government
Services 4

Branch
City,
Country
Duration

Days

Months

Days

Months

Days

Months

Days

Months

Previous Visa Applications of Spouse ( If Applicable)


Have You Previously Applied For Permanent Resident
Visa or Visitor Or Temporary Resident Visa?

Yes

No

(If Yes Then Please Give Us The


Details Along With File Number)

Designed By: Rohit | Page 7 of 11

ICC Canada Immigration Solutions Inc


Blood Relation In Canada of Spouse (If Applicable) Please put N/A which is not applicable to you.
Any Blood Relation In Canada Who Are Citizen Or
Permanent Resident
Relative 1

Yes

No

Relative

(If Yes Then Pleas Give Following


Details:Relative 3

Relative 4

Name
Relation

Present Address

Work History Till Date-For Past Ten Years (If Applicable) Please put N/A which is not applicable to you.
Company 1

Company 2

Company 3

Company 4

Company 5

Name of
Company
Designation
Date From
Month/Year
Date To
Month/Year
Salary
City
Country
Family Details Father and Mother of Spouse ( If Applicable)
Father

Mother

Family Name
Given Name
Date Of Birth
Place Of Birth
Marital Status
Present Address
City
State/Province
Country
Postal Code
Date Of Death
(If Deceased)

Occupation
Other comments related to spouse father and mother

Designed By: Rohit | Page 8 of 11

ICC Canada Immigration Solutions Inc


Family Details Brothers of Spouse (If Applicable)
Brother 1

Brother 2

Brother 3

Brother 4

Sister 2

Sister 3

Sister 4

Family Name
Given Name
Date of Birth
Place of Birth
Marital Status
Occupation
Date Of Death
(If Deceased)

Present Address
City
Postal Code
Province /State
Country
Family Details - Sisters of Spouse (If Applicable)
Sister 1
Family Name
Given Name
Date of Birth
Place of Birth
Marital Status
Occupation
Date Of Death
(If Deceased)

Present Address
City
Postal Code
Province /State
Country
Declaration
All the information provided is true and accurate as per my knowledge, ICC have no responsibility in the event of refusal
for misrepresentation based on the information provided above.
Name of Applicant

Signature of Applicant

Date
Designed By: Rohit | Page 9 of 11

ICC Canada Immigration Solutions Inc


Document Checklist
Document Type
Visa processing Fee in form of Bank Draft in favor of The Receiver General for Canada
Letter of acceptance from the educational institute in Canada (original and one copy)
Proof of sufficient funds for your studies and stay in Canada. (Bank Statements, Loan papers, etc)
Police Certificate from each country or territory where you have lived for six consecutive months or
longer since reaching the age of 18.
All educational documents
Proof of employment for yourself or your parents if you are dependent on their income
Original valid passport, preferably must be valid for at least 2 years
All previous passports (originals).
2 recent passport-sized photographs. The name and date of birth must be written on the reverse of
the photograph.
Copies of Valid Passport (pages bearing name and picture)
Copy of National Identity Card, translated in English and Notary Attested
Property papers with translation (if in any other language then English or French) and valuation.
Curriculum vitae/rsum if you are aged 20 or older If Applicable
Study plan
If you or any accompanying family member has a criminal conviction, an original police certificate
and a personal explanation of events leading to the conviction(s)
Misrepresentation declaration

India
INR
5,470.00

Pakistan
PKR
8,700.00

UK

Australia
AUD
75.00
125.00

Copy

Original

Copy

Copy

Copies

Notary
Attested

Copies

Copies

Designed By: Rohit | Page 10 of 11

ICC Canada Immigration Solutions Inc


Document Checklist Continued
Document Type
IELTS test results taken within last 24 months
AS A PREFERRED OPTION for proof of funds: A copy of an Educational Loan from an Indian
Chartered Bank equivalent to at least 80% of tuition +living + travel expenses for one academic year
(normally, first years tuition, unless already paid, plus $8000). See information on the next page for
the list of acceptable banks. (For India Only)
Copy of receipts for payment provided by the University (pre-payment of first term is strongly
recommended)
Form 16 for salaried employees or income tax return document.
Affidavit of Support from the individual(s) providing you financial assistance for your program. The
letter must indicate their occupation and relationship to you, the number of dependents they have and
their full contact details. You should also provide a letter from the employer of the individual(s)
providing you financial assistance for your program, clearly indicating employer contact details and
full street address of business location.
Scholarships or any financial assistance or award from a government or other funding agency must
be presented on official letter stating the full amount of the award, its duration and any governing
conditions
Attach your bank statement of transactions for the past 6 months - or evidence of funds from the
account that you will be drawing funds once in Canada

India

Pakistan

UK

Australia

Designed By: Rohit | Page 11 of 11

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