Canada Immigration Assessment
Please complete the following information as accurately as possible.
Personal Information
Salutation:
Mr.
Mrs.
Ms.
Miss
Dr
Full Name: *
Date of Birth: *
Country of Current Permanent:
Country of Citizenship: *
Address: *
Tel: *
Fax:
Email:
Family Information
Name of Your Spouse (if any):
Spouse Date of Birth(if any):
Age of Oldest Child (if any):
Education
Highest Education: *
High School/Equivalent
Bachelors
Masters
PhD
Certification/Diploma
Other
Description for Other:
how long was the course of study:
1 Year
2 Years
3 Years
4 Years
5 Years
more
Total years of education:
Less than 12
12 Years
13 Years
14 Years
15 Years
16 Years
17 Years
18 Years
19 Years
20 Years
21 Years
22 Years
more
Do you have a second Bs. degree?
Yes
No
Spouse's highest education:
High School/Equivalent
Bachelors
Masters
PhD
Certification/Diploma
Other
Description for Other:
how long was the course of study:
1 Year
2 Years
3 Years
4 Years
5 Years
more
Spouse's total years of education:
Less than 12
12 Years
13 Years
14 Years
15 Years
16 Years
17 Years
18 Years
19 Years
20 Years
21 Years
22 Years
more
Employment & Work Experience
Your current occupation: *
How long have you worked in your current occupation?
Have you worked in any other occupation in the past 10 years? (If so, please describe)
What is your spouse's current occupation? (if any)
How long has your spouse worked in that occupation?
Has your spouse worked in any other occupation in the last 10 years? (If so, please describe)
Language Skills
What is your ability to Speak, Read and Write English?
High Proficiency
Moderate Proficiency
Basic
Not at all
What is your ability to Speak, Read and Write French?
High Proficiency
Moderate Proficiency
Basic
Not at all
What is your spouse's ability to Speak, Read and Write English?(if any)
High Proficiency
Moderate Proficiency
Basic
Not at all
What is your spouse's ability to Speak, Read and Write French?(if any)
High Proficiency
Moderate Proficiency
Basic
Not at all
Employment in Canada
Do you or your spouse have a confirmed offer of permanent employment in Canada at this time?
Yes
No
If Yes please describe:
If no, do you have any definite prospects for employment in Canada at this time?
Yes
No
If yes, please describe:
what are your reasons for believing that you will become economically successful in Canada?
Family & Connections in Canada
Do you or your spouse, have any relatives in Canada who are either Permanent Residents or Canadian Citizens (brother, sister, aunt, uncle, niece, nephew, father, mother, spouse or child)?
Yes
No
If yes, describe the relationship to you?
If not, are there other more distant relations or close friends living in Canada who would be prepared to offer assistance to you? (Please explain)
Your Immigration Plans
Please describe why you want to immigrate to Canada?