DM New Doc 1
DM New Doc 1
DM New Doc 1
ASSESSMENT FORM
Note: Please don’t use short forms. Kindly write the full name of study, board / university,
employer organization, job designation, job responsibilities etc.
NAME Date of Birth
ADDRESS
Qualification Stream of Study / Start End Percentage Board / University Mode of Study
Subjects studied Year Year
(Regular /
Distance /
Correspondence)
Work Experience
Have you ever been refused from any country under any visa category? (Yes / No)
IELTS/PTE
(Embassy requirement is General IELTS but Assessing Authority may demand Academic IELTS)
Applicant
Spouse
SPOUSE DETAILS
Qualification Stream of Study / Start End Percentage Board / University Mode of Study
Subjects studied Year Year
(Regular /
Distance /
Correspondence)
Name of Organization Designation Joining Leaving Part time / Full Job Duties
Date Date time
(In brief)
Have your spouse ever been refused from any country under any visa category? (Yes / No) NO
If Yes, kindly give the following details. How many times got refused -
CHILDREN DETAILS
Name Date of Birth Relation State / Province Residing Visa Status (PR / Citizen /
since Student / Work Permit)
(dd-mm-yy)
- - - - - -
FAMILY FRIEND