Personal Information

The personal information submitted below will serve to facilitate the analysis of your profile during the personalized consultation.

Notes:
Please provide the required information below in preparation for your consultation.
All information is kept highly confidential and will not be shared with any third party outside Martineau & Mindicanu.
For the purpose of this form, the applicant is considered the person who scheduled the consultation and is completing the form. Details can be added on the spouse, if applicable.
It is important to use the same email as the one used upon scheduling the consultation.
The fields marked with * are mandatory.

Step 1 of 8

GENERAL INFORMATION
Name*
First Last
Sex*
- Female
- Male
Date of birth*
Year
Month
Day
Marital status*
Number of dependent children under 21 years old*
Please enter a number from 0 to 99.
Please enter the age of each dependent child*

CONTACT INFORMATION
Email*
Enter Email Confirm Email
Phone*
Address*
Street Address City State / Province / Region ZIP / Postal Code Country

EDUCATION
Highest level of education*
Field of education*
Graduation date*
Year
Month
Day
Country*
Other degrees?*
- Yes
- No
List other degrees*
Level Field Graduation date Country

Present / Most Recent Employment Position*
Starting date*
Year
Month
Day
Ending date
Year
Month
Day
Main duties
Company
Country*
Job type*
Other previous positions held in the last 5 years

Location

Due to COVID-19 restrictions all consultations take place online via Zoom. Taxes apply if you are in Canada at the moment of consultation.