Canada Immigration
Initial Assessment
Name
*
First Name
Last Name
Email Address
*
Mobile Number
*
Format: (000) 000-0000.
Date of birth
*
-
Day
-
Month
Year
Place of Birth
Gender
*
Male
Female
Civil Status
*
Single
Married
Divorced
Widowed
Country of Citizenship
*
Is your current Country of Residence other than your country of Citizenship?
*
Yes
No
Country of Residence
*
Are you legally resident in your country of residence?
*
Yes
No
Academic level (select the highest degree/diploma level)
*
Please Select
PH.D / Doctoral Certificate
Master’s Degree, or professional degree needed to practice in a licensed profession
Two or more certificates, diplomas or degrees. One must be a program of three or more years.
Bachelor’s degree (three or more year program at university, college, trade or technical school, or other institution)
Two year program at a university, college, trade or technical school, or other institution
One year program at a university, college, trade or technical school, or other institution
Secondary diploma (high school graduation)
Less than secondary (high school)
None
Designation of your Highest Degree/Diploma
*
Number of Years in each Degree
Rows
You
First Bachelors Degree
1 Year
2 Years
3 Years
4 Years
Second Bachelors Degree (if applicable)
1 Year
2 Years
3 Years
4 Years
First Masters Degree
1 Year
2 Years
3 Years
4 Years
Second Masters Degree (if applicable)
1 Year
2 Years
3 Years
4 Years
Do you have IELTS test result which is less than two years old?
*
Yes
No
IELTS Test Date (if you haven't taken the IELTS yet, then leave this field blank or mention tentative test date)
-
Day
-
Month
Year
Date
Your English Language Test Score (IELTS) (Provide Actual Score if available otherwise provide Tentative Score that you can get in the test)
*
Rows
Listening
Reading
Writing
Speaking
English
9.0
8.5
8.0
7.5
7.0
6.5
6.0
5.5
5.0
0-4.5
9.0
8.5
8.0
7.5
7.0
6.5
6.0
5.5
5.0
0-4.5
9.0
8.5
8.0
7.5
7.0
6.5
6.0
5.5
5.0
0-4.5
9.0
8.5
8.0
7.5
7.0
6.5
6.0
5.5
5.0
0-4.5
Your Professional Experience
*
Rows
At most 1 year
1-2 year (s)
2-3 years
> = 3 years
In Canada
Outside Canada
Please list your Professional Experience (Job Title and Job Description)
*
Spouse / Partner Information
Date of birth of your Spouse
*
-
Month
-
Day
Year
Country of Citizenship
*
Is your Spouse's current Country of Residence other than your country of Citizenship?
*
Yes
No
Country of residence
*
is your spouse legally resident in your country of residence?
*
Yes
No
Academic level (select the highest degree/diploma level) of your spouse
*
Please Select
PH.D / Doctoral Certificate
Master’s Degree, or professional degree needed to practice in a licensed profession
Two or more certificates, diplomas or degrees. One must be a program of three or more years.
Bachelor’s degree (three or more year program at university, college, trade or technical school, or other institution)
Two year program at a university, college, trade or technical school, or other institution
One year program at a university, college, trade or technical school, or other institution
Secondary diploma (high school graduation)
Less than secondary (high school)
None
Designation of your spouse's highest Degree/Diploma
*
Does your spouse have IELTS test result which is less than two years old?
*
Yes
No
IELTS Test Date (if you haven't taken the IELTS yet, then leave this field blank or mention tentative test date)
-
Day
-
Month
Year
Date
Language level of your Spouse (Provide Actual IELTS Score if available, otherwise provide Tentative Score that you can get in the test)
*
Rows
Listening
Reading
Writing
Speaking
English
9.0
8.5
8.0
7.5
7.0
6.5
6.0
5.5
5.0
0-4.5
9.0
8.5
8.0
7.5
7.0
6.5
6.0
5.5
5.0
0-4.5
9.0
8.5
8.0
7.5
7.0
6.5
6.0
5.5
5.0
0-4.5
9.0
8.5
8.0
7.5
7.0
6.5
6.0
5.5
5.0
0-4.5
Your Spouse's Professional Experience
*
Rows
At most 1 year
1-2 year (s)
2-3 years
> = 3 years
In Canada
Outside Canada
Please list the professional experiences (Job Title & Job Description) of your spouse
*
Number of children
*
Rows
0
1
2
3
4+
Less than 13 years old
between 13 to 17 years
between 18 to 22 years
22 years +
Additional Information
Do you (or your spouse) have a Brother or Sister living in Canada who are at least 18 years old?
*
Please Select
Yes
No
In which provinces do you [or your spouse] have family and acquaintances?
Rows
Grandparents, Parents, Brothers / sisters (including half-brothers and sisters)
Uncles and aunts (direct)
Acquaintance
Alberta
British Columbia
Prince Edward Island
Manitoba
Nova Scotia
New Brunswick
Nunavut
Ontario
Québec
Saskatchewan
Newfoundland and Labrador
Northwest Territories
Yukon
Have you or your spouse studied in Canada
Rows
You
Your Spouse
Never Studied in Canada
Primary / Secondary Level
1, 2 or 3+ year at University, College, Technical School or other
Masters degree / Licensed profession
PH.D / Doctoral Certificate
Do you (or your spouse) have a job offer in Canada?
*
Please Select
Yes
No
Have you (or your spouse) ever submitted an immigration profile / visa application to the Government of Canada?
*
Please Select
Yes
No
Please provide full details of your submission and response received (Was the Visa application Refused or Approved?)
*
Have you been referred by someone?
First Name
Last Name
Submit
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