Immigration no.

Date

I wish to Migrate to Canada/Australia

Name (Mr./Ms.)

DOB

Age (Years)

Months

Address

Phone

Marital Status (Single/Married/Divorcee)

Total Work Experience Years (Attach Separate Sheet if Required)

Name DOB Age (Years) Months

Total Work Experience Years (Attach Separate Sheet if Required)

1. Son / Daughter Information

2. Have you ever been Abroad. If Yes, Which Countries

3. Have you ever been convicted of or are currently charged with any time or offence in any Country. If yes, Please Specify.

4. Do you have any serious Physical or Mental Disorder? If yes, Please Specify.

5. 1) For Which Countries do you have Valid Visitors Visa?

5. 2) Have you ever Been Deported from any Country?

5. 3) Have you ever been refused Tourist or any Other Visas? (If Yes, Please Attach Details)

6. How did you Come to know about Magic Lamp International?

7. VISA Category for

8. Passport no.

9. Place of Living in Australia/ Canada

10. Case to be assessed by

11. Course to be Taken (Cricos no.) University/ College

12. Funds Available

13. Govt. Fees to be Paid