MCICS - Assessments

Online Assessment - Study Permit (Student Visa) Free Assessment

Student Details

Preferred Title

Mr Mrs Ms Miss Dr Other

*Family Name:

*Given Name:

*Gender

Male Female

*Date of Birth

Day /Month/ Year

*Place/Country of Birth

Place

Country

*Your Citizenship

*Marital Status

Married
Never Married
Common Law
Engaged
Widowed
Divorced

*Children

Yes No

*Does your family have any close relatives or friends in Canada?

Yes No

If you have marked Yes, please provide details.

Character Details

*Have you been convicted for any criminal activity?

Yes No

If you have marked Yes, please provide details.

Health Details

*Do you have any medical conditions?

Yes No

If you have marked Yes, please provide details

Address Details

*Residential address

*Telephone Number
(Please include area code)

Fax
(Please include area code)

Mobile Phone

*Email Address

Previous Education

Name of Secondary School

Attended

From To

Highest Qualification gained

Name of University or Technical College

Attended

From To

Highest Qualification gained

Are you currently attending school?

Yes No

If you have marked Yes, please provide details

English

I have studied English for:

years

I have taken the following English tests:

	Date	Score
IELTS
TOEFL

Have you graduated from an accredited English Medium School?

Please provide details on your knowledge in the English language

Canada Study Plan

*What course do you want to do in Canada?

*Funds available for Tuition Fees and your stay in Canada

*I found out about MCICS Education Centre from: