General Assessment Form

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Please fill in the forms in English ONLY
 
 Title

Gender

   
Last Name

FirstName          

 

 

Nationality
 Date of Birth (dd/mm/yyyy)        
Your Marital Status:  
Category
Educational Qualification

Field of Study

How many years have you studied including elementary school?

  

 

 Present Occupation:
How long have you been working in the profession?
 

Address  

               

City                        State/Province

Postal Code                 Country

Phone # in Home Country 

Fax # in Home Country     

Phone # of your contact in Canada

Fax # of your contact in Canada   

 E-mail  Address    

 

Spouse & Children Information

Will your spouse be accompanying you to Canada at this time? Yes No

Number of children accompanying you to Canada 

(children above 19 years of age have to be still dependent on you and are still in school)

Below age 19.................... ...............19 years or older...............

 

Spouse's Informationils

 Title  Gender  
Last Name

First Name         

 Nationality

   
 Date of Birth (dd/mm/yyyy)         E-mail
Educational Qualification

Field of Study

How many years have you studied including elementary school?

  

 

 Present Occupation
How long has your Spouse been working in the profession?
Paste Your Resume Here

Paste Your Spouse's Resume Here

Relative Residing in Canada

Do you (or your accompanying spouse) have a relative residing in Canada, who is a citizen or holds permanent resident status in Canada?   Yes No
If so, please provide us with the relationship of the closest relative and the Province or Territory in which your relative resides.
Relationship:      Province 

 

Do you have a job offer in CanadaYesNo

If so what is the occupation?

 

How much money do you have in the way of funds? (in $US)  much do you have in the way of funds? (in US$)

a. Savings on deposit:  

b. Value of other assets:

c. Amount you intend to take with you :

Have you been refused admission to, or ordered to leave, Canada or any other country Yes No

If Yes, when and why:

               

              Your Language Proficiency

 
First Canadian Official Language
(either English or French)
Read Write Speak Listen
High Proficiency
(Maximum of sixteen (16) points)

Moderate Proficiency
(Maximum of eight (8) points)

Basic Proficiency
(Maximum of two (2) points)

No Proficiency
(No points)
 
Second Canadian Official Language
(either English or French)
Read Write Speak Listen
High Proficiency
(Maximum of eight (8) points)

Moderate Proficiency
(Maximum of eight (8) points)

Basic Proficiency
(Maximum of two (2) points)

No Proficiency
(No points)

   

   Your Spouse's Language Proficiency

 
First Canadian Official Language
(either English or French)
Read Write Speak Listen
High Proficiency
(Maximum of sixteen (16) points)

Moderate Proficiency
(Maximum of eight (8) points)

Basic Proficiency
(Maximum of two (2) points)

No Proficiency
(No points)
 
Second Canadian Official Language
(either English or French)
Read Write Speak Listen
High Proficiency
(Maximum of eight (8) points)

Moderate Proficiency
(Maximum of eight (8) points)

Basic Proficiency
(Maximum of two (2) points)

No Proficiency
(No points)

.

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                                    By clicking the "Send Assessment" button below and submitting
                                                this message, I hereby declare that the information being transmitted
                                                is truthful, complete, and accurate to the best of my knowledge.

 

 


                                                                          

                                                           

 

 

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