QUESTIONNAIRE
Mohali: F-212, Phase 8b, /industrial Area, Sector 74, Ph. : 0172 - 4656644, 4654844 Chandigarh : SCO
6-7, Sec. 41 D, Level I & II, Ph. : 0172 - 5060522, 5014522 Jalandhar : Office No. 317, 2nd Floor ., Prestige
Chambers, Ph. : 0181 4640322 Ludhiana : SCO 668, Top Fir, Dashmesh Complex, Pakhowal Road, Ph. :
0161 4840322 Amritsar : SCO 52, Pushpa Tower, Ranjit Avenue, B Block, Ph : 0183-5096822 Email:
info@landmarkimmigration.com Website: www.landmarkimmigration.com
1. Main Applicant Name_______________________________
2. Contact No._______________________________________
3. Email ____________________________________________
4. Inviter’s Detail:
Name_______________________________________________
Relation with Applicant_________________________________
Contact No. ________________________________________
Email ID_____________________________________________
Status (Study/Work/PR etc.) _____________________________
5. Marital Status:
Unmarried Married Separated
Engaged Widowed Divorced
6. Marriage Details:
● Spouse Name: ____________________________
● Date of Birth of Spouse: ____________________
● Marriage Date: Day_______ Month_________ Year________
● City/Town_______________________ Country____________
● Occupation of the spouse: ____________________________
● Address (if not living together) _______________________________________
7. I have been married more than once: Yes/No
If Yes then:
● Name of previous spouse _____________________________
● Date of Divorce/ Date of Death ________________________
● Date of Birth of Previous spouse: _______________________
● Date of Previous Marriage: ____________________________
8. Parents Details:
Relation Name of the Parents Date of Birth Occupation
(Estimated year is (If expired then Date of
required) Death)
Father
Mother
9. Children’s Details:
Do you have any biological/adopted /step-children: Yes/No
If Yes then give details:
Name Date of Birth Married/Single Address
ii
Iii
10. Education Details (School/college/University) (must give details of Matric/Senior
Secondary/Graduation/Post Graduation):
From: To:
Level of Study School/Facility Name: City/Town
mm/yyyy mm/yyyy
11. Employment Details (Last 10 Years Work Details):
Start Date: End Date: Occupation/ Company/ Department City/Town
mm/yyyy mm/yyyy Designation
12. Travel History:
Arrival Date: Departure Date: Visited Country: Purpose (Tourism/ Study/
mm/yyyy mm/yyyy Work etc.)
13. Biometric For Canada (Done / Not Done)
14. Refusal Detail:
Country Refused Visa Type (Study/Visitor/Work etc.) Year
15. Payment Detail:
Total Processing fees Pending Fees VFS Charges
16. Our Created Gmail Id: ________________________
I declared that the above particulars are true.
Signature of the Applicant: _______________
Date: _______________
Place: _______________