Free Assessment
Important Note
All information you provide us with is held in strict confidence and will not be disclosed to anyone. Your information is only used to assess you for immigrating to Canada. You should enter a valid email address so that we can send you our reply.
Please complete the form in English only.
*
Required fields
CONTACT INFORMATION
Last Name:
*
First Name:
*
Gender:
Male
Female
Email Address:
*
Phone Number:
*
Fax Number:
City/Country of Residence:
Citizenship:
How old are you?
How did you find us?
select one...
Word of mouth
Television advertising
Recommendation from client
Newspaper/Magazine ad
Google Search
Yahoo Search
Other
If other, please specify:
MARITAL INFORMATION
Marital Status:
select one...
Never married
Married
Common Law
Separated
Divorced
Widowed
How many children do you have?
How old are your children?
LANGUAGE PROFICIENCY
Please indicate your proficiency in both the English and French languages:
HIGH -
You can communicate effectively in most social and work situations.
MODERATE -
You can communicate comfortably in familiar social and work situations.
BASIC -
You can communicate in predictable contexts and on familiar topics, but with difficulty.
ENGLISH PROFICIENCY
Speak:
Read:
Write:
Listen:
select...
High
Moderate
Basic
Not at all
select...
High
Moderate
Basic
Not at all
select...
High
Moderate
Basic
Not at all
select...
High
Moderate
Basic
Not at all
FRENCH PROFICIENCY
Speak:
Read:
Write:
Listen:
select...
High
Moderate
Basic
Not at all
select...
High
Moderate
Basic
Not at all
select...
High
Moderate
Basic
Not at all
select...
High
Moderate
Basic
Not at all
Have you taken any language tests for English or French?
Yes
No
If yes, which test did you take and when?
Overall score:
YOUR EDUCATION
Please indicate your highest level of completed education:
select one...
PhD
Master's degree
Bachelor's degree
College/trade diploma - 3 years
College/trade diploma - 2 years
College/trade diploma - 1 year
High school diploma
Did not complete high school
Other
Your field of study:
Number of years of study from grade 1 to present:
YOUR WORK EXPERIENCE
Starting with the most recent, please list the
last three jobs
you have held.
FULL JOB TITLE
NUMBER OF YEARS
NUMBER OF HOURS/WEEK
You may paste your resume (optional) or add further details here:
BUSINESS EXPERIENCE
Have you ever owned or managed a business enterprise?
Yes
No
Your total years of business experience?
Have you ever managed more than 5 people?
Yes
No
Please tell us the position you have held in the last 10 years.
NAME OF BUSINESS
POSITION
YEARS (From-To)
Your total world-wide net worth in Canadian dollars (CDN$):
Briefly, please tell us about the business and your role in it (owner
or manager). Also tell us what you want to do in Canada.
Have you ever been self-employed as a musician or artist or in athletics?
Yes
No
Have you ever owned or managed a farm?
Yes
No
SPOUSE/COMMON-LAW PARTNER EDUCATION
If you have a spouse or common-law partner, please complete this section:
What is the highest level of completed formal education that your spouse/common-law partner has?
select one...
PhD
Master's degree
Bachelor's degree
College/trade diploma - 3 years
College/trade diploma - 2 years
College/trade diploma - 1 year
High school diploma
Did not complete high school
Other
Spouse's field of study:
Number of years of study from grade 1 to present:
STUDY OR WORK IN CANADA
Do you or your spouse/common-law partner have a 2 year (or longer) post secondary degree from Canada?
Yes
No
Have you or your spouse/common-law partner ever worked in Canada for 1 year or longer?
Yes
No
Do you currently have an offer of employment from an employer in Canada?
Yes
No
RELATIVES IN CANADA
Do you or your spouse/common-law partner have any relatives in Canada?
select one...
No relatives in Canada
Parent(s)
Grandparent(s)
Sister or brother
Aunt or uncle
Niece or nephew
Daughter or son
Spouse or common-law partner
If yes, where in Canada?
select one...
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland & Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
WHEN YOU ARE IN CANADA
Do you want to work for an employer in Canada?
Yes
No
Do you want to open up your own business in Canada?
Yes
No
Have you owned or part-owned a business in the last 5 years?
Yes
No
If applicable, please list the name(s) of the business(es) and the percentage (%) of ownership you have held during the last 5 years:
NAME OF BUSINESS
% OWNED
NUMBER OF EMPLOYEES
YEARS
(From-To)
What is your total net worth?
How much funds do you have for transfer to Canada?
If there is any additional information that you want to give us, or if you have any comments or special requests, you may tell us here:
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