Potential New Client Form & Initial Consultation Agreement Family Name(required) First Name(required) Date of Birth (YYYY)(required) Please Select 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 Date of Birth (MM)(required) Please Select JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC Date of Birth (DD)(required) Please Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Do you have a Representative?(required) Yes No If Yes, Seeking: Second Opinion New Representative Current Status In Canada(required) Please Select Student Worker Visitor PR Citizenship Status Expiry Date - If applicable Email(required) Telephone #(required) Address (Suite, Street, Province, Postal Code, Country)(required) How did you hear about us?(required) Please Select Google Online Ads News Paper Social Media Family Friends Other If other, Please specify: This E-Initial Consultation Agreement is made Between the Client and Regulated Canadian Immigration Consultant (RCIC) Sueng (Daniel) Shin (the “RCIC”), Membership Number R515808.(required) I agree This Agreement shall be governed by the laws in effect in the Province/Territory of British Columbia, and the federal laws of Canada applicable therein. Please be advised that Daniel Shin is a member in good standing of the Immigration Consultants of Canada Regulatory Council (ICCRC), and as such, is bound by its Bylaw, Code of Professional Ethics, and Regulations.(required) I agree I agree terms and conditions of this Initial Consultation Agreement:(required) I agree Consultation fee of:(required) Submit Δ Share this:TwitterFacebookLike this:Like Loading...
DRim Immigration Services 