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Please fill
out and submit the online Assessment Form to see if you
qualify for immigration to Canada. There is no cost or
obligation. Once received, we will assess your
qualifications based on the information provided. Our
assessment review will then be sent to you via e-mail so
be sure to provide your correct e-mail address. All
Information submitted will be held strictly
confidential.
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| Contact
Information ( required field * )
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| Surname (family
name): |
* |
| First name: |
* |
| Other names (if
any): |
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| Home
Address
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| Current
address: |
* |
| City: |
* |
| State / Province: |
* |
| Country: |
* |
| Postal / Zip code: |
* |
| Phone number
(home): |
* |
| Phone number
(bus.): |
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| Fax number: |
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| E-mail address: |
* |
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| Personal
Information
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Sex:
Male
Female |
| Date of Birth: |
, 19 |
City and Country of Birth: *
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| Present Marital Status: |
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Relationship of your closest relative living
in Canada:
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| Languages
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| English: |
Speak |
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| |
Read |
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| |
Write |
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|
Listen |
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| French: |
Speak |
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| |
Read |
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Write |
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|
Listen |
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| Education
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| How many years of full-time education
(including primary and secondary schooling) do you
have?
Years
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Do you have a secondary school
diploma?
- Yes
- No
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Do you have a Bachelor's degree issued by a
recognized university?
-
Yes
-
No
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Do you have any other university
degrees?
- Yes
- No
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- If so, at
what level?
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Do you have a trade school, vocational,
apprenticeship or college diploma?
-
Yes
-
No
If so,
how many years of full-time study did it require
(including any period of workplace training included
in the program)?
Years
-
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Please list below complete details regarding
your post-secondary education:
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Institution #1:
From - To (mm/yy to
mm/yy)
Name & Location of
School
Type & Date of
Certificate
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Institution #2:
From - To (mm/yy to
mm/yy)
Name & Location of
School
Type & Date of
Certificate
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Institution #3:
From - To (mm/yy to
mm/yy)
Name & Location of
School
Type & Date of
Certificate
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| Spouse's
Education
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| How many years of full-time education
(including primary and secondary schooling) does your
spouse (or common-law partner) have?
Years
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Does he/she have a secondary school
diploma?
Yes
No
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Does he/she have a Bachelor's degree issued by
a recognized university?
-
Yes
-
No
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Does he/she have any other university
degrees?
-
Yes
- No
-
- If so, at
what level?
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Does he/she have a trade school, vocational,
apprenticeship or college diploma?
-
Yes
-
No
If so,
how many years of full-time study did it require
(including any period of workplace training included
in the program)?
Years
-
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Please list below complete details regarding
your spouse's post-secondary
education:
|
Institution #1:
From - To (mm/yy to
mm/yy)
Name & Location of
School
Type & Date of
Certificate
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Institution #2:
From - To (mm/yy to
mm/yy)
Name & Location of
School
Type & Date of
Certificate
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Institution #3:
From - To (mm/yy to
mm/yy)
Name & Location of
School
Type & Date of
Certificate
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Employment
History
Work History for the Past 10 Years
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Name of current employer:
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Job title:
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Date started
(month/year):
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Duties - Please provide a brief description of
your duties in the box below:
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Previous employer #1:
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Job title:
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Date started
(month/year):
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Duties - Please provide a brief description of
your duties in the box below:
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Previous employer #2:
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Job title:
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Date started
(month/year):
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Duties - Please provide a brief description of
your duties in the box below:
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Have you or your spouse ever worked or studied
in Canada?
Yes
No
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If so, please provide details and length of
period of work or study.
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Do you currently have a job offer from an
employer in Canada?
Yes
No
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If so, please provide
details.
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Do you have a destination in
Canada?
Yes
No
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If so, which province?
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Would you like to be considered for a
Provincial Nominee Program?
Yes
No |
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Enter your Questions or
Comments:
By clicking the "Send
Assessment" button below and submitting
this
message, I hereby declare that the information
being transmitted
is truthful, complete, and
accurate to the best of my
knowledge.
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THANK YOU!
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