Justice Research Application Form

The Inter-Cultural Association (ICA) is leading a study about serious legal problems experienced by immigrants in Canada.

We are looking for participants to take part in an online interview through ZOOM. If you are interested, please fill out the form below.

Participation is voluntary and will not affect your relationship with your settlement organization. The information that you provide will be completely confidential and will not be attributed to you in any way.

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* 1. Full Name

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* 2. Gender

Male

Female

Non-Binary

Prefer not to answer

Other (please specify)

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* 3. Age

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* 4. Country of Origin

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* 5. Which year did you move to Canada?

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* 6. Current are of residency

Greater Victoria Area

Greater Vancouver Area

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* 7. What is your current immigration status in Canada? Check all that apply

Temporary Resident (student or work visa)

Permanent Resident

Naturalized Citizen

Refugee Background

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* 8. What is the highest level of education you have completed?

Did not finish High School

High School

Technical/Vocational Training

Bachelor Degree (3-5 year college program)

Master’s Degree or other post-graduate training

Doctoral Degree (PhD. MD, EdD DVM, DDS, JD, etc.)

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* 9. What is your current employment status? Check all that apply

Self-employed

Student

Working full-time

Working part-time

Unemployed and looking for work

Unemployed but not currently looking for work

Unemployed because of disability

Retired

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* 10. Have you had legal problems to do with any of the following? Check all that apply

Finances, banks, and/or debt

Employer or job

House or apartment

Harassment or discrimination

A large purchase or service

Immigration

Health

School/College

Family Conflict

Neighbourhood Conflict

Police

Government assistance

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* 11. Do you prefer a translator to be present for the interview?

Yes

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* 12. If yes, please let us know for what language?

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* 13. Contact Information

Email Address

Phone Number