Application Review Intake Form If you are human, leave this field blank. Doherty Fultz Immigration offers reviews of complete applications by phone, Google Meet, and Skype for extra assurance that your application will not be returned or refused due to missing or insufficient documentation or information. You complete your entire application as it will be submitted to the government, and our licensed consultants will review all information on forms and documents to advise if any information is missing, incorrect, or can be strengthened to increase your chances of approval. In order to book an application review, please complete the following form. After submitting the form, we will contact you to arrange an appointment. **Due to covid-19, we are not accepting in-person appointments at this time. Full Name * Email * Phone * Skype Name (if applicable) Gender * Date of birth * Highest level of education received * Occupation * Employer’s name * Street address * City/Town * Province/State * Zip/Postal * Nationality * Country of residence * Choose one Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Colombia Comoros Congo Costa Rica Côte d'Ivoire Croatia Cuba Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Norway Northern Mariana Islands Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Yemen Zambia Zimbabwe Status in Canada Status Date Expiry (if applicable) Do you have a Spouse/Common-Law Partner? No Spouse Common-law partner Spouse/Partner’s Name (if applicable) Spouse/Partner’s Nationality How long have you been married or in a common-law relationship? Have you or your spouse ever been convicted of a criminal offence? No Yes Please briefly describe you immigration matter so we can assist you * How did you hear about us? * Referred by a friend or family member Google search/maps/reviews Facebook Instagram Moving 2 Canada Returning Client Other By typing my first and last name, I hereby certify that this document is legally executed by the person named herein as the Client, and that I understand and acknowledge all of the above information to be true, correct, and complete. * Today’s Date * By signing above, I indicate that I understand I am obliged to pay a fee of $595.00 + tax where applicable. I understand that in-person consultation fees must be paid at the time of appointment booking, and consultation fees paid are non-refundable for missed or cancelled appointments. I understand that all quotes given for services at the time of a consultation remain valid for 90 days as long as no circumstances discussed during the consultation change. All information discussed or disclosed in the context of a consultation at Doherty Fultz Immigration is STRICTLY CONFIDENTIAL, and is bound by representative-client privilege. These terms and conditions shall be governed by the laws in effect in the Province of Ontario, Canada. Please be advised that Anthony Doherty and Cassandra Fultz of Doherty Fultz Immigration are members in good standing of the Immigration Consultants of Canada Regulatory Council (ICCRC), and as such, are bound by its By-laws, Code of Professional Ethics, and associated Regulations. By signing this intake agreement, you acknowledge that any interaction with IRCC or CBSA undertaken by you without retaining an Doherty Fultz Immigration RCIC as a legal representative is done at your own risk, and Doherty Fultz Immigration accepts no responsibility for the outcome of any such interaction. Submit
