Canada Immigration Assessment Form

Canada Immigration Assessment Form
Before you fill out the form, please keep the following points in mind:

1. Completing the assessment form accurately will ensure a thorough case review. 2. Your information is confidential and will only be evaluated for the purpose of considering your immigration to Canada.
1. Are you currently inside or Out side Canada?*

Inside of CanadaOutside of Canada
2. Which Program Are you interested in?*
Personal Information:
Full Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Country of Citizenship*
Country Of Residence*
Marital Status*
Preferred Language:*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
E-mail*
example@example.com
Education:
1. Highest Level of Education Completed*
2. Field of Study*
3. Institution Name*
4. Country of Institution *
Work Experience:
1. Total years of work Experience*
2. Job Title ( NOC Code)*
3. Full Time or Part Time*
4. Industry*
5. Country Of Employment*
Language Proficiency:
1. Have you taken an approved English language test?*
2. English Language Test Score
3. Have you taken an approved French language test?*
4. Language Test Score
Family Information:
1. Number of Dependents ( Children under 22):
2. Do you have relatives in Canada?*

YesNo
3. Please specify relationship and location:
Financial Information:
1. Do you have the required proof of settlement?*

YesNo
2. Estimated Settlement Funds (in CAD):
Immigration History:
1. Have you applied for a Canadian visa or immigration program before??*

YesNo
2. Please Specify what type of visa you have applied?
3. Have you ever been refused a visa for Canada?*

YesNo
4. Please Specify what type of visa?
5. What is your current residency and visa type?
6. Validity period of your current visa?
How did you hear about us?*
What is the Best Time to Contact You?*
Descriptions:
Should be Empty:

Canada Immigration Assessment Form

Before you fill out the form, please keep the following points in mind:

Education:

Work Experience:

Language Proficiency:

Family Information:

Financial Information:

Immigration History: