EBBI Study Permit Assessment — Client Intake (Blank)

How to fill this out: Write dates as Day / Month / Year (e.g. 04 / 07 / 2026). Where a question does not apply, write N/A. Print clearly in block letters. Return by mail, in person, or scan and email to admin@explorebeyondborders.ca. Expected response: 2–3 business days.

1. Personal Information

Last Name

First Name

Date of Birth (D/M/Y)

Gender / sex (as on passport)

Father's full name (as on birth certificate)

Citizenship / Nationality

Current marital status

SingleMarriedCommon-lawDivorcedWidowedSeparated

Date of marriage or common-law (if applicable) (D/M/Y)

Spouse or partner — full name (if married or common-law)

Spouse or partner — date of birth (D/M/Y)

Native language or mother tongue

Can you communicate in English and/or French? (English / French / English and French / Neither)

Sex (as shown on your passport) (Female / Male / Another gender)

Place of birth (city)

Country of birth

Email Address

Phone Number

Currently Living In (In Canada / Outside Canada)

Current Status in Canada (if applicable)

If in Canada, date your current status expires (D/M/Y)

Country where you live now

Mailing address

2. Passport

IMM 1294 asks for these on the passport screen. Sending them now avoids a second call.

Passport number

Country of issue

Date of issue (D/M/Y)

Date of expiry (D/M/Y)

UCI, if you have applied to IRCC before

National identity document number (if you have one)

3. Intended Study Program

Have you already been accepted by a Designated Learning Institution (DLI)?

Yes - I have a Letter of AcceptanceApplied, awaiting decisionNo - still researching schools/programs

Name of school

DLI number

Level of study (Primary school; Secondary school; ESL or FSL; College or trade; University; Master's; Doctorate; Other)

Program of study / field

Program length

City and province of the school

Program start date (D/M/Y)

Program end date (D/M/Y)

Tuition (CAD)

Room, board, and other living costs (CAD)

4. Financial Information

How do you plan to demonstrate proof of funds?

Personal savings / bank statementsGuaranteed Investment Certificate (GIC)Scholarship or sponsorship from institutionFamily member sponsoring costsEducation loanNot sure yet

Funds available for your stay (CAD)

Name on the bank statements or GIC

5. Background

IRCC assesses whether applicants intend to leave Canada at the end of their authorized stay. Describing your ties to your home country helps EBBI prepare a stronger application.

Previous school or institution

Field of study

Education — from (D/M/Y)

Education — to (D/M/Y)

Have you taken a test to assess your English or French?

If yes — which test

Do you have ties (family, property, employment) in your home country?

Any previous Canadian visa refusal? NoYes

If yes — country, year, and what was refused

Have you previously applied to enter or remain in Canada? NoYes

Have you ever stayed beyond your status, or studied or worked in Canada without authorization? NoYes

Have you ever been arrested, charged, or convicted of a criminal offence in any country? NoYes

Have you served in the military, a militia, or a security organization? NoYes

6. Document Status

Check all documents you currently have ready.

Documents ready — check all that apply

Valid passportLetter of AcceptanceProof of fundsAcademic transcriptsLanguage test resultsStatement of Purpose / study planMedical exam (if required)

Additional Information

Client Declaration

I declare that the information provided is true, complete, and accurate to the best of my knowledge. This form is for assessment only, does not constitute legal advice, and does not guarantee any immigration outcome. I have read the Privacy Policy and Legal Notice at explorebeyondborders.ca. I authorize EBBI to share this information with supervising counsel, Atty. George M. Garvida.

☐ I have read and agree to the above declaration

Full name (print)

Signature

Date (D/M/Y)

For EBBI Staff Use Only

Received by

Date received (D/M/Y)

Reference code assigned

Pathway flagged

Online option: explorebeyondborders.ca/immigration-study-permit-assessment.html · Legal Notice: explorebeyondborders.ca/legal-disclaimer.html