Assessment Form
Personal Details
Name *
Date of Birth *
Day 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 Month 1 2 3 4 5 6 7 8 9 10 11 12 Year 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003
Address *
City *
State *
Country *
Phone *
Mobile
Email ID *
Academic Profile
Year
% age
Subjects
Class 10th
Class 12th
Degree/Diploma
Additional Qualification
IELTS
TOFEL
GRE
GMAT
Other Information
Gap in Studies (If Any)
Course Option (Course your are interested in)*
Country Option (Country your are interested in)*
Work Experience (If Applicable)
Name of the Employer
Experience (in years)
Designation
2nd Employer
Financial Details(To enable us to advice you correct on finances for visa, please indicate your current finances below)
In Bank Account
In Fixed Deposits (FD's)
Salary
Rental Income
Rs. US $ CND $ AUS $ Other
Agriculture Income
Property
Sponsorship Money
From (Sponsorship)
Do you or your spouse/Fiancée, common Law Partner and children have any serious medical problem? If yes please state relationship of the person and give brief details:*
Have you or your spouse/Fiancée, common Law Partner and children have been charged / convicted of a criminal offence? If Yes, give brief details:*
