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Y AXIS OVERSEAS CAREER EVALUATION FORM

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CONFIDENTIAL

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Begin career overseas

PRIMARY OBJECTIVE
I would like to Work Study Visit Migrate Invest/Do Business Working Holiday In USA Canada UK Australia New Zealand Ireland Germany Switzerland Russia Singapore Dubai China Other ______________________________________________
(You can choose multiple options)

Personal Information
First Name: _________________Middle Name_________________ Last Name_____________ Email ID:
Check here if you like to receive regular updates on overseas careers and visas

________________________________________________________________

Mailing Address: ___________________________________________________________________________________ Address 2: _________________________________________________________________________ City _________________________________State_______________________ Zip ________________ Contact Number (Mobile) __________________________ Res: _____________________________ Date of Birth: _________________ Age: _______________

Profession: ______________________________ Years of experience________________

Marital Status: Single Engaged Married Divorced

All information furnished in this form is true and can be supported by documentary evidence. __________________________ Signature of the Applicant ________________________ Date

Please fill this page and the next page before a consultant can meet with you.

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PROFESSIONAL PROFILE
ACADEMIC PROFILE
Level Masters Bachelors Diploma XII Degree Institute Year of Passing Grade

Are you Salaried Self Employed? If self employed, please specify the nature of business:_________________________________

WORK EXPERIENCE

WORK EXPERIENCE
Name of the Company Title Years of Experience Industry Location

Total number of years of full time work experience ________

ENGLISH PROFICIENCY
Have you taken the IELTS/TOEFL exam? Yes No Date Taken _____________________________________ If yes, which module have you taken? General Academic Band______________ Do you have knowledge of French? Yes No If yes, please tick appropriate level of Proficiency Beginners Medium High Level

FINANCES
What has been your annual income during the previous year?______________________ What is the total value of the assets you hold? Fixed Assets ____________________ Liquid Assets ____________________________ Do you file IT Returns? Yes No

FAMILY DETAILS
If married, please give the following details for your spouse:
First Name: _______________________Middle Name___________ Last Name_____________ Age: ___________________ Qualification: ________________________ Total number of years of full time work experience: ____________ None
Do you have children: Yes No If yes, where do your spouse & children live? Inside India Outside India

OVERSEAS TRAVEL HISTORY

Have you ever traveled overseas before? Yes
Name of the country Purpose Year

No
Duration of stay

Do you currently hold a visa for any country? Yes No Have you been rejected by any consulate? Yes No If yes, please provide details below:

Name of the consulate

Type of Visa Applied for

When rejected?
This Month Last month less than 6 months 1 year more than 1 year This Month Last month less than 6 months 1 year more than 1 year

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MIGRATION SERVICES SECTION

For Migration Applicants only
I would like to Migrate through the following program: Canada: Federal Migration Regional Migration UK HSMP Australia SIMS ENS New Zealand XYZ Singapore Other ______________________________________________ I dont have a specific idea. I request you to recommend whatever is best for me. I require Post Landing Services REASON FOR MIGRATION Children education Dollar income Healthcare facilities Better retirement Better career prospects Better work environment Career Break Time Frame Less than 6 month less than 1 year 1-2 years 2-3 years More than 3 years

Relationship
Do you have a close blood relative (Brother, Sister, Uncle, Aunt, Niece, Nephew, Father, Mother) in Australia /Canada/New Zealand? Yes No If yes:

COUNTRY
Australia Canada New Zealand USA UK

RELATIONSHIP

LOCATION

WORK OVERSEAS SECTION

For those wanting to search for work from India itself
Country of Interest: USA Canada UK Australia New Zealand Ireland Germany Switzerland Russia Singapore Dubai China Other _______________________________ My migration petition has been approved. I do not want to enter the country without a job offer. I would like to apply for a job where the employer will be able to sponsor my migration papers. I would like to apply for a job from India itself and a work permit is sufficient.

CONSULATE SERVICE SECTION

Student: Please use the forms on Page 5 Businessmen: Please use the form on Page 6
I require Documentation Services Visa Interview Orientation Schedule an Interview Date Purpose: Tourist Business Job Search Working Holiday Country of visit: in USA Canada UK Australia New Zealand Ireland Germany Switzerland Russia Singapore Dubai China Other _______________________________ Purpose of visit Visit friends Holiday Attend a conference Attend an interview Show Working Holiday Specify ____________________________________________________________________ Trade

For Temporary/Short Stay/Visit Visa Applicants only

Which type of Specific Visa are you holding/intending to hold?______________ (E.g. F-1Visa) Who is going to finance your visit? ______________________________ Do you have any contacts in the country to be visited? Yes No Do you have any invitation from overseas contacts? Yes No How long do you want to go on your first visit? 1 wk 2 wks 1-month months More than 3 months

2 months

Have you already scheduled the interview with the Consulate? If so, when is the date_________________

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REFER A FRIEND OR RELATIVE and get a 5% referral fee*

Name of the Referrer: Name________________________ E-mail ______________________Mobile______________________________ Enter your referrals name/s below: _______________________E-mail________________ Mobile__________________________________________ _______________________E-mail________________ Mobile __________________________________________ _______________________E-mail________________ Mobile __________________________________________

If you have received this application by mail: Mail it by back or Fill it up and visit any of our offices

Y AXIS Hyderabad: First Floor, GS Chambers, Nagarjuna circle, Banjara Hills, Hyderabad 5000 82 Y AXIS Secunderabd: Ground Floor, Mayfair, SD Road, Secunderabad 5000 03 Y AXIS Somajiguda: 3rd Floor, Dega Towers, Raj Bhavan Road, Somajiguda, Hyderabad - 500 082 Y AXIS M G Road: 11th Floor, Prestige Meridian, MG Road, Bangalore 560 001 Y AXIS Koramangala # 612, 2nd floor, 80 feet road, 6th Block, Koramangala, Bangalore - 560 095 Y AXIS Chennai: Ground Floor, Aashirvaad Towers, McNichols Road, Chetpet, Chennai 600 031 Y AXIS Pune: 1st Floor 121 & 122, Connaught Place, Bund Garden Road, Pune 411001 Y AXIS Mumbai: Kotian Nirman, B-306, Third Floor, Andheri Link Road, Andheri (West), Mumbai 58 Y AXIS Delhi: LG 25, International Trade Tower, Nehru Place, Delhi - 110 019 Y AXIS Gurgaon: Vipul Agora, First Floor, Suite 117, M.G. Road, Gurgaon 122002

Any questions or comments?

Call 939 640 1515 E-mail customerservice@y-axis.com SMS NRI to 7333

FOR OFFICE USE ONLY

NOTES: ________________________________________________________________________________________ Referrers Name ___________________Counselor Name _____ ______________Office ______________________ Suitable for: ___________________________________________ Recommended: _________________________________________ Next Action: Suitable for
Follow up Will call Will visit Ignore

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