Filici-Palacio Immigration Services Inc. logo
Filici-Immigration Specialist Vilma Filici

Our Mission

At Filici-Palacio Immigration Services Incorporated, we are committed to providing honest and professional service to ensure the doors to Canada open for you.

Phone (416) 482 - 1575
Fax (416) 482 - 2267
keyLine
 

Immigration Assessment

Do you qualify to Immigrate to Canada?

Thank you for your interest in Filici-Palacio Immigration Services. If you are looking to submit an assessment form that will help you determine your probability of success to immigrate to Canada.

Answer the questions to the following form and submit
PLEASE READ

This questionnaire is not a legal document. The following questions will help us find the best possible option to process your permanent residence in Canada application. All the information that you provide is confidential. Please answer the questions clearly and in detail. If you are married or engaged, please have your spouse/fiancé complete another questionnaire. Should you have children over the age of 19, please have them complete a questionnaire as well.

All the information that you provide is confidential please review our Privacy Policy for complete details

* yes I have read the Privacy Policy statement.
Please acknowledge Privacy Policy.
IMPORTANT!

Please ensure that your confirmation of payment of $25 is included within your application. If you need to make a payment, please click here.

If you not sure if your case will have merit use the Screening page free of charge. QUESTIONNAIRES WITHOUT THE CONFIRMATION NUMBER OF PAYMENT WILL NOT BE PROCESSED.

General Information

* Confirmation of Payment Order
Number Received via (EMAIL or PHONE)

Required!Invalid format.
*Last Name*First Name    

A value is requiredMinimum number of characters not metExceeded maximum number of characters.		    
*Email Address

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* Street Name and Number

A value is requiredExceeded maximum number of characters.
* City * Country * Postal Code / Zip Code

A value is requiredExceeded maximum number of characters.
A value is requiredExceeded maximum number of characters.
A value is requiredExceeded maximum number of characters.
* Phone Number Fax Number  

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Select Gender Male
Female
 
* Your Date of Birth Required!
Required!
Required!
* Marital Status: Please Select One Please select a valid item.
Spouse Date of Birth

* Number of children under
the age of 22

 (If it doesn't apply please enter 0)

* Number of children 22 or over

 (If it doesn't apply please enter 0)

* How many are married?

 (If it doesn't apply please enter 0)

* How many are full time students?

 (If it doesn't apply please enter 0)

Citizenship

* Select country of birth
Please select a valid item. Please select an item.
* Select country of current citizenship
Please select a valid item.
* If you are not residing in your country of citizenship, please indicate your status in the country of your current residence

 
Please select a valid item.
 
Other ( please state if not listed)
Passport Number
Passport Expiry

Language Skills

English and French are Canada's two official languages. What is your level of ability in each of these languages?
Select your level of ability in English for the following:
* Speak * Read * Write * Understand

Please select an item.
Please select an item.
Please select an item.
Please select an item.
Select your level of ability in French for the following:
* Speak * Read * Write * Understand

Please select an item.
Please select an item.
Please select an item.
Please select an item.

Employment History

Please describe your employment history for the past 10 years.
You may be asked to supply a resume in order to complete the process. 
You will be contacted

Job Description #1

Name of employer
Position
Job Title
Date Employed - From: month  year
  To: month  year
Please include a detailed description of the job and your duties in the space below.  

Job Description #2

Name of employer
Position
Job Title
Date Employed - From: month  year
  To: month  year
Please include a detailed description of the job and your duties in the space below.  

Education

Check all that apply Secondary School / Collegiate Diploma
Professional Training / Trade
Community College
University (Bachelor Degree)
University (Master Degree)
University (Doctorate)

Please give details about your Post-Secondary education in the chart below.
Begin with most current information.

1st Entry

Name of institution
Year completed
Number of Years of Program
Field of Study
Select type of diploma granted
Other (Please type in type of
diploma if not listed)

2nd Entry (If applicable)

Name of institution
Year completed
Number of Years of Program
Field of Study
Select type of diploma granted

Other (Please type in type of
diploma if not listed)

Spouse  
Employment History

Please describe your employment history for the past 10 years.
You may be asked to supply a resume in order to complete the process. 
You will be contacted

Job Description #1

Name of employer
Position
Job Title
Date Employed - From: month  year
  To: month  year
Please include a detailed description of the job and your duties in the space below.  

Spouse
Job Description #2

Name of employer
Position
Job Title
Date Employed - From: month  year
  To: month  year
Please include a detailed description of the job and your duties in the space below.  

Spouse
Education

Check all that apply Secondary School / Collegiate Diploma
Professional Training / Trade
Community College
University (Bachelor Degree)
University (Master Degree)
University (Doctorate)
Please give details about your Post-Secondary education in the chart below.
Begin with most current information.

Spouse
1st Entry

Name of institution
Year completed
Number of Years of Program
Field of Study
Select type of diploma granted
Other (Please type in type of
diploma if not listed)

Spouse
2nd Entry (If applicable)

Name of institution
Year completed
Number of Years of Program
Field of Study
Select type of diploma granted
Other (Please type in type of
diploma if not listed)

Relations & Contacts

Do you have any of the following relatives living in Canada who are either permanent residents or Canadian citizens?
Parents Spouse Children Brother/sister
Uncle/aunt Niece/nephew Girlfriend/boyfriend    
Please provide us with the name, address and phone number of your relative or friend who will be our contact in Canada
Last Name First Name  
 
Email Address
Phone Number Fax Number  

Health questions

How is your general health?
List any physical or mental illness you have, as well as the nature of the illness
Do any of your dependents, have or have had any medical problems?  
If yes, please specify in the space below:

Additional questions

Do you have a drivers licence?
Yes No
Do you wish to immigrate to Canada to establish your own business?
Yes No
If yes describe what type of business and outline your business experiences in the space below
Please indicate your assets (show assets in US funds)
Transferable money Property Monthly pension
Other (please explain)
Do you have any investments?
If yes please explain in the space below:

Immigration reference

Do you have or have you had any problems with the authorities in Canada or any other country? Give details below.  
If yes, please specify crime(s) and conviction(s) and any punishment
(fine, jail time, probation) in the space below
Have you previously applied for permanent residence to Canada?
Yes No
If yes, when:  month year
Name of office
What were the results? Describe in the space below
Have you or any of your family been refused a visitor's visa to Canada?
If yes, when:  month year
Country
Have you or your dependents been deported or ordered to leave Canada or any other country?
If yes, explain in the space provided
Do you have an U.S.A. visa?
Yes No
If Yes; expiry date
Have you ever been refused an U.S.A. visa?
Yes No
If yes, explain in the space provided

Press Clear to clear form Press Submit to send form

  Please insure that all answers are entered that apply Items marked with a * must be completed for this form to be submitted Thank you!

This questionnaire is not a legal document. The following questions will help us find the best possible option to process your permanent residence in Canada application. All the information that you provide is confidential. Please answer the questions clearly and in detail. If you are married or engaged, please have your spouse/fiancé complete another questionnaire. Should you have children over the age of 19, please have them complete a questionnaire as well.

FILICI-PALACIO IMMIGRATION SERVICES INC.
2323 Yonge Street, Suite 604 - Toronto, Ontario, Canada, M4P 2C9
Phone: 416.482.1575 - Fax: 416.482.2267

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