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Free Assessment

Please take a moment to complete. If married, your spouse should also complete a form separately. Feedback will be provided by email as soon as possible. Thank you for your time!


Personal Information

⇒ Title:

⇒ Family Name (surname):

⇒ Given Name(s):

⇒ Date of Birth:

⇒ Sex:
Male Female 

⇒ Marital status:

⇒ Name of spouse / partner (if any):

⇒ Number of dependent children:

⇒ Place of birth (city or town):

⇒ Country of birth:

⇒ I am a citizen of:

⇒ Country of residence (if other than citizenship):

⇒ Immigration status in the country of residence:

⇒ Period of time in the country of residence:

⇒ Date of entry (if you reside in Canada):

⇒ Mailing address:

⇒ Phone number (home):

⇒ Phone number (work):

⇒ Phone number (mobile):

⇒ Fax number:

⇒ Your Email:

Language Skills

⇒ English

Speak:

Write:  

Read:  

Listen: 

⇒ Have you ever taken an IELTS English test? Your score:

⇒ French

Speak:

Write:  

Read:  

Listen: 

⇒ Other language(s):

Education Details

⇒ Primary:

Number of years:

⇒ Secondary or High School:

Name and place of school:           
Degrees, certificates or diplomas:
Number of years completed:

⇒ College or University:

Name and place of institution:      
Degrees, certificates or diplomas:
Number of years completed:

Name and place of institution:      
Degrees, certificates or diplomas:
Number of years completed:

Name and place of institution:      
Degrees, certificates or diplomas:
Number of years completed:

Name and place of institution:      
Degrees, certificates or diplomas:
Number of years completed:

⇒ Trade, vocational or apprenticeship:

Name and place of institution:      
Degrees, certificates or diplomas:
Number of years completed:

Name and place of institution:      
Degrees, certificates or diplomas:
Number of years completed:

Work Experience

⇒ Current occupation:

Employer:   
Occupation:
Number of years:

⇒ Previous work experience:

Employer:   
Occupation:
Number of years:

Employer:   
Occupation:
Number of years:

Employer:   
Occupation:
Number of years:

Employer:   
Occupation:
Number of years:

Employer:   
Occupation:
Number of years:

⇒ My intended occupation in Canada:

⇒ Alternate occupation:

Person(s) in Canada

Name:

Relationship (e.g. relative, friend, employer, etc):

Address:

Name:

Relationship (e.g. relative, friend, employer, etc):

Address:

Name:

Relationship (e.g. relative, friend, employer, etc):

Address:

Name:

Relationship (e.g. relative, friend, employer, etc):

Address:

Destination in Canada

⇒ City or town:

⇒ Province or territory:

Financial Status (Net worth)

⇒ Savings:

⇒ Property value:

⇒ Shares, stocks, bonds:

⇒ Other items of worth:

⇒ Total net worth ($US or $Ca):

Other Information

⇒ Have you ever been convicted of or currently charged with a crime or offence in any country?
 Yes No

⇒ Have you ever previously applied for an immigrant or visitor visa to Canada?
 Yes No

⇒ Have you ever been refused an immigrant or visitor visa to Canada?
 Yes No

⇒ Have you ever been refused admission to, or ordered to leave Canada?
 Yes No

⇒ Do you suffer from or have you ever been treated for any serious physical or mental disability?
 Yes No

⇒ If you answered "yes" to any of the above questions, please provide full details here:

Additional Information

⇒ Please provide any additional information or comments relating to employment history, education, or financial status not provided in the form, or any other information that may be relevant to immigrating to Canada:

Assessment Form Verification

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