Family Sponsorship Free Assessment Form

Questions about the Sponsor (Canadian Citizen or Permanent Resident)

A. Sponsor Personal Details

• Family Name*

• Given Name

• Gender
• Male Female

• Address

• Home Phone Number

• Business Phone Number

• Mobile Phone Number*

• Fax Number

• E-mail Address*

• Confirm E-mail Address*

• Alternate E-mail Address

• Place of Birth

• Citizenship

• Date of Birth

• Are you a Canadian citizen?
• Yes No

• Are you a Canadian permanent resident?
• Yes No

• Country of Residence

B. Who do you want to sponsor? (check one or more)

• Spouse (husband or wife) Common-law partner Conjugal Partner Child Parent Grandparent Orphan Adopted child

• Please provide details about who you want to sponsor including the number of people you want to sponsor and their relationship to you and to each other

If you need more information about the types of relatives you can sponsor, please refer to the Family Class page.

C. Sponsor Annual Income

• Are You Employed?
• Yes No

• What was your total income for the last year in Canadian dollars?

• Are you married, or do you have a common-law partner?
• Yes No

• How many children under the age of 19 do you have?

• How many people do you intend to sponsor?

• What will be your total family size, including yourself, when the person(s) you want to sponsor arrive in Canada?

• Please provide any important details about your family size and income here

D. Sponsor Eligibility Details

• Have you yourself been sponsored within the past 5 years?
• Yes No

• Have you sponsored anyone else within the past 3 years?
• Yes No

• Are you subject to a removal order?
• Yes No

• Are you detained in any penitentiary, jail, reformatory, or prison?
• Yes No

• Have you been convicted of a sexual offence within the past 5 years?
• Yes No

• Have you been convicted of a violent crime or a crime that resulted in bodily harm within the past 5 years?
• Yes No

• Are you in default of any previous undertaking or any support payments ordered by a court?
• Yes No

• Are you an undischarged bankrupt?
• Yes No

• Are you in receipt of social assistance for any reason other than a disability?
• Yes No

• If you answered yes to any of the above questions, please provide details here

2. Questions for the Applicant (person to be sponsored)

A. Applicant Personal Details

• Family Name

• Given Name

• Gender
• Male Female

• Date of Birth

• Address

• Home Phone Number

• Business phone number

• Mobile Phone Number

• Fax Number

• E-mail Address

• Confirm E-mail address

• Alternate E-mail address

• Place of Birth

• Citizenship

• Are you married or do you have a common-law partner?
• Yes No

• Do you have any children?
• Yes No

• If yes, how many children do you have and what are their ages?

B. Applicant Admissibility

Have you, your spouse, or any of your children

• Had any serious disease or physical or psychological disorder?
• Yes No

• Been convicted of or are currently charged with a criminal offence in any country?
• Yes No

• Applied previously for a temporary visa to Canada?
• Yes No

• Applied previously for permanent residence in Canada?
• Yes No

• Been refused a visa to Canada or any other country?
• Yes No

• Been refused admission to or order removed from Canada or any other country?
• Yes No

• Been involved in the commission of human rights violations, acts of subversion, espionage, terrorism, or organized criminality?
• Yes No

• If you have replied “yes” to any of the above questions, please provide details

C. Final Details

• If there is anything else that you believe is important in relation to your case please note it here.

Declaration

• I ( , ) certify that the above information provided by me in the Free Assessment is true. *

• Furthermore, I consent to the law office of Matthew Jeffery, Barrister & Solicitor, contacting me in relation to the above Free Assessment. *

• Please select the Triangle and click the Submit button.

  

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