Assessment Questionnaire

This assessment will allow us to determine possible immigration routes to Canada. If you have a spouse, have them complete their own copy of this assessment. Note: A completed Assessment Questionnaire will only be used for paid consultations.

Name *

Email *

Phone Number *

Date of Birth *

YYYY-MM-DD

Country of Residence *

Country of Citizenship *

Marital Status *

Highest Level of Education *

Graduation Date

YYYY-MM-DD

Location of School

City and Country

Total Number of Years in School

Degree Specialization

Designation Awarded

Industry of Trade

License Required/Regulated?

1. Work Experience *

Occupation title within the last 10 years

Duration of Position *

Number of years

Main Duties *

List the 5 main tasks you perform within this occupation title.

Location of Work Performed *

City and Country

2. Work Experience

Occupation title within the last 10 years (if different from above)

Duration of Position

Number of years

Main Duties

List the 5 main tasks you perform within this occupation title.

Location of Work Performed

City and Country

Have you owned or managed business within the last 5 years? *

If yes, provide details

Explain the type of business and industry

Personal Net Worth *

What is the total value of all your assets in Canadian dollars?

Liquid Available Funds *

How much funds do you have available in cash?

Have you ever travelled to Canada? *

If yes, provide details

Explain the date you entered into Canada, your immigration status in Canada and the duration of your travel.

Have you previously made any Canadian immigration application that has been refused? *

If yes, provide details

Explain the type of application, the date of the application and the reason for refusal

Do you have any family in Canada? *

If yes, provide details

State the relationship, their immigration status and the province they reside in

Do you know anyone in Canada that might be interested in hiring you? *

What is your preferred destination in Canada? *

City and Province

Are you fluent in English? *

Have you taken the IELTS English exam?

If yes, state the date of the exam along with your scores in the following order: Reading, Writing, Listening and Speaking.

Are you fluent in French? *

Have you taken the TOEFF French exam?

If yes, state the date of the exam along with your Oral and Written scores.

Do you have any dependents? *

Dependent: Spouse, son and/or daughter

If yes, provide details

State the relationship and their age. Note: if they are over the age of 18, have them complete their own assessment.

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