FREE Pre-Assessment Form

FREE Pre-Assessment Form

Your Work Experience
Have you obtained any paid work experience in the last 10 years?

YesNo
What is your most recent occupation in the last 10 years?
Field of Work
Employment Type
Year work began
Year work ended
Job Duration
Location of Job

Your Canadian Languange Profiency
Level of your English
Level of your French

Your Spouse or Common-Law Patner's Information
Name

First NameLast Name
Age
Have you obtained any post-secondary education or training?

YesNo
Field of Study
Have you obtained any paid work experience in the last 10 years?

YesNo
Field of Work
Level of your English
Level of your French

Other Information
Do you or your partner have any relative family in Canada?*

YesNo
Did you or your partner have any issues with the law in any country?*

YesNo
If yes, please describe.
Did you or your partner have any issues with the Canadian Immigration Law?*

YesNo
If yes, please describe.
Do you or your partner have any chronic illness or medical condition?*

YesNo
If yes, please describe.
Is there any other information that you feel is important to share as part of your pre-assessment?
Collection and Processing of Personal Information

***COLLECTION AND PROCESSING OF PERSONAL INFORMATION We only collect this personal information solely and exclusively to carry out our pre-evaluation that our prospective clients request to profile and provide them with instructions on which Canadian immigration program is best for them and at the same time keep them informed of the latest Canadian immigration news.

Any responses will only be sent to you from the yalopezimmigrationconsulting@gmail.com email address to prevent fraud or someone using our name to contact you.
Certification of True

I affirm and certify that all the information and answers to questions herein are complete, true and correct to the best of my knowledge and belief.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Date

MonthDayYear
Date
Signature

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Your Contact Information (Principal Applicant)

Your Education and Training

Your Work Experience

Your Canadian Languange Profiency

Your Spouse or Common-Law Patner's Information

Other Information