Between Mr. ___________________, hereinafter designated as "the applicant" and Mr. MICHEL BEAUBIEN from Michel Beaubien & Associates, located at 390 Notre-Dame West, Suite 468, Montreal, Quebec, Canada, hereinafter designated as "the consultant".

The applicant hereby appoints the consultant to handle his application regarding his immigration to Canada. The consultant agrees to make every effort to prepare and assist the applicant in submitting his application to the Governments of Quebec and Canada.

The applicant agrees to pay to the consultant the following fees:

- A first payment of ___________________ upon signing this Agreement.

- A second and final payment of ___________________ upon completing a successful interview with an Immigration Officer or if he is accepted without an interview.

The above-mentioned fees do not include those required by the immigration authorities, the designated medical practitioner (for required medical examination) and the translators.

All payments may be done by personal cheque, bank draft, credit card, Western Union, Moneygram or by transfer to the consultant's bank account.

The applicant will receive a permanent resident visa upon completing the immigration process. Should the applicant not succeed in obtaining a permanent resident visa, the consultant agrees to refund the professional fees paid by the applicant. However, the consultant will not refund the applicant should the latter fail to obtain permanent residence status due to the following reasons:

• medical inadmissibility;
• criminal background or national security;
• false declaration or document;
• disregarding consultant's instructions;
• cancellation of application;
• advise the immigration authorities not to use consultant's as representative;
• change of marital status during the immigration process, without prior notice to the consultant, resulting in a refusal.

If the applicant's civil status changes during the procedure, additional fees of One Thousand American dollars ($1,000 US) will be required to add his spouse to the file, and Two Hundred and Fifty American dollars ($250 US) for a newborn.

The laws of Canada and of the Province of Quebec shall govern this agreement. The parties hereto agree that they have specifically requested that this agreement be drafted in the English language.

The parties hereto have signed on the date and place hereinafter set forth.

Montreal, on this _____ day of _____________.


____________________________
Applicant


____________________________
Mr. Michel Beaubien
Certified canadian immigration consultant
Membre of the Canadian Society of Immigration Consultants
Number: M041105