MASTER IELTS LLQP INSTITUTE - VISITOR'S FORM Order Number DATE * HOW DID YOU HEAR ABOUT US? * DATE OF ARRIVAL IN CANADA RESIDENTIAL STATUS TEMPORARY RESIDENT PERMANENT RESIDENT CANADIAN CITIZEN CELL NUMBER EMERGENCY CONTACT NO. E-MAIL ADDRESS MARITAL STATUS MARRIED UNMARRIED NO. OF CHILDREN COURSE HLLQP IELTS-GEN IELTS-AC PREVIOUS SCORE IF EXAM GIVEN Please read the following statements and answer YES OR NO. 1. Are you exhibiting any common flu symptoms i.e. fever or cough? YES NO 2. Did you had any person-to-person contact with someone has exhibited corona virus symptoms in the last 7 days. YES NO 3. Did you visit an area where there has been a significant outbreak, such as corona virus or influenza, in the last 14 days? YES NO
