FREE ASSESSMENT

PERSONAL PROFILE:

1. Age:*

2. Country of residence:*

3. Preferred destination in Canada:*

4. Marital Status:*

Single

Married

Common-Law Partner

5. Do you have any children under the age of 19?*

Yes

No

How many children do you have under the age of 19?

YOUR LANGUAGE SKILLS:

Please describe proficiency in English/French under each of the four skills listed below. (choose one answer)

1. ENGLISH:*

2. FRENCH:*

YOUR EDUCATION and TRAINING:

1. Have you completed high school(secondary school)? *

Yes

No

2. Have you received any education or training other than high school?*

Yes

No

3. Type of program

4. Program duration

5. Did you complete this program?

Yes

No

6. Location:

Inside Canada

CITY and PROVINCE

Outside Canada

CITY and COUNTRY

7. Add another education or training program:

YOUR WORK HISTORY:

1. Have you done any paid work during the last 10 years?*

Yes

No

Starting with your current (or most recent) job, please list all the paid work you have done during the last 10 years.

2. Occupation:

3. Length of work

4. When

5. Location:

Inside Canada

CITY and PROVINCE

Outside Canada

CITY and COUNTRY

6. Work hours

Full time (At least of 30 hours per week)

Part time (At least 15 hours per week)

Less than 15 hours per week

7. Type of job

On the payroll (i.e. commercial, government or other)

Self-Employed or working for your own company or business

8. Add another job:

FAMILY OR FRIENDS IN CANADA

1. Do you have any family members or relatives living in Canada and who are 18 years or older? *

Yes

No

Please list all your and / or your spouse / common - law partner’s relatives in Canada.

2. Relationship – select relationship:

3. Select residency status in Canada of family member:

4. Living in – select Province/Territory

5. Since

Less than 1 year

More than 1 year, but less than 2 years

2 years or longer

6. Add another person:

ADDITIONAL INFORMATION:

1. Have you ever applied for an immigrant or temporary resident visa to Canada (i.e. visitor/student/worker)? *

Yes

No

2. How many times?*

3. When was the last time you applied for Canadian visa?*

4. Have you ever been rejected Canadian Visa or any other country? *

Yes

No

5. Have you ever been to Canada? *

Yes

No

If YES - where, what year and how long?

6. Have you ever applied previously for permanent status in Canada?*

Yes

No

7. Have you ever been refused admission to, or ordered to leave Canada or any other country? *

Yes

No

8. Have you ever had any serious disease or physical or mental disorder? *

Yes

No

9. Have you ever been convicted of or are currently charged with any crime or offence in any country?*

Yes

No

10. Have you ever been involved in the commission of a war crime or a crime against humanity?*

Yes

No

CONTACT INFORMATION:

1. First name:*

2. Last name:*

3. E-mail: *

4. Telephone:*

You may provide additional information that you think would be relevant to your immigration assessment.

	Expert	Very good	Good	Competent	Modest	Limited	None at all

Writing:
Reading:
Speaking:
Listening:

	Expert	Very good	Good	Competent	Modest	Limited	None at all

Writing:
Reading:
Speaking:
Listening:

COMPLETE YOUR EVALUATION BELOW:

Contact

Follow Us on:

About Us