Assessment Page

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1. Contact Information

Salutation:*

First Name:*

Last Name:*

Email:*

Phone:*

Other Phone:

2. Profile

Nationality:

Country of Current Residence

Preferred Destination in Canada*

Age:*

Marital Status:*

Do you have any child?

Do you have children over 18 years of age with a physical or mental disability?

3. Education

Have you completed high school (Also known as secondary school)?

Have you received any education/training after high school?

4. Work Experience

Have you had paid employment during the last 10 years ?

5. Language Skills

English Language

Speaking

Reading

Writing

Listening

French Language

Speaking

Reading

Writing

Listening

6. Canadian Connections

Work Experience in Canada

Have you been employed in Canada as a temporary foreign worker?

Job Offer in Canada

Do you have an official/written offer of employment from a Canadian employer?

Stay in Canada

Have you visited Canada before?

Friend/Family Member

Do you have family or close friends living in Canada?

7. Personal Net Worth

Personal net worth means the total value of your assets (bank accounts, stocks, bonds, real estate, etc) MINUS the total of your liabilities (mortgages, loans, credit card balances, etc).

Please Include assets and debts/liabilities of spouse/common-law partner (if applicable)
Also Include value of share ownership in companies you own (if applicable)

Currency

What is your networth?

Do you have experience managing a business?

Have you ever owned and operated your own business?

8. Security and Medical

Have you ever been convicted of a criminal offense?

Do you or any of your immediate family members have a medical condition?

9. Questions & Comments

Additional Information

Education/Training

Occupation-1

Occupation-2

Occupation-3

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