Canadian Immigration Assessment Form for Independent (Skilled Workers) Immigration

IMP0RTANT: Canada Skilled Workers Points requirement goes down to 67 points.

If you are living in the UK call 020 7842 0800 or complete the assessment form for a FREE ASSESSMENT.

About You :

1. Title*:

2. First Name/s*:

3. Last Name*:

4. Date of Birth*:

5. Place of Birth*:

6. Gender*:

Male Female

7. Nationality*:

8. Present Occupation*:

9. Nominated Occupation*:

(See Management or highly skilled occupation list)

10. How long have you been working in nominated occupation?*

11. Present address:

Street Address

Town/City

Post Code/Zip Code

Country

12. Telephone No including Country Code:

13. Fax No:

14. E-mail*:

15. Web Page:

16. Annual Income (Can$):

Other details :

17. Are your plans for emigration Temporary or permanent?*

18. Do you have family or dependants who will emigrate with you?*

Yes No

If ‘Yes’ please give details:

Age	Relationship to you	Occupation

19. Do you or your spouse/common law partner have relatives or ancestors in Canada?

Age	Relationship to you	Occupation	Nationality	Immigration Status

20. Have you had any type of visa to Canada before?*

Yes No

If yes, please give the following details:

a. Type:

b. Date Issued:

c. Place Issued:

d. Length of validity:

21. Have you ever been refused a visa?*

Yes No

If yes, please give details:

22. How much do you have in the way of funds? (in Can$)
You can convert currency at the Universal Currency Convertor

a. Savings on deposit:

b. Value of other assets:

c. Amount you intend to take with you (Please be advised, that CAD 10,000 and CAD 2,000 for each dependent is recommended):*

23. Please state your fluency in English (PLEASE TICK):*

Speaking:

Reading:

Writing:

Understanding:

24. Please state your fluency in French (PLEASE TICK):*

Speaking:

Reading:

Writing:

Understanding:

25. Do you have a job offer*

Yes No

a. If so what is the occupation?

(See Management or highly skilled occupation list)

b. Has the job been approved by Human Resources Development Canada?

Yes No

26. Have you or any of your immediate family members ever been convicted of any crime (however minor the offence)?*

Yes No

If yes, please include full details:

27. Have you or any of your immediate family had any serious health problems?*

Yes No

If yes, please include full details:

28. Why do you wish to emigrate?

Work Experience and Qualifications

29. Please provide full details of your work experience.*

1. Work experience

Dates of Employment*:	From To
Employing Company*:
Job Title*:
Skills used / Responsibilities*:
Country*:

2. Work experience

Dates of Employment:	From To
Employing Company:
Job Title:
Skills used / Responsibilities:
Country:

3. Work experience

Dates of Employment:	From To
Employing Company:
Job Title:
Skills used / Responsibilities:
Country:

30. Please provide full details of your educational qualifications.

1. Qualification

Dates of study*:	From To
University/ College/School*:
Subject*:
Qualification*:
Country*:

2. Qualification

Dates of study:	From To
University/ College/School:
Subject:
Qualification:
Country:

3. Qualification

Dates of study:	From To
University/ College/School:
Subject:
Qualification:
Country:

Work Experience and Qualifications for your Spouse or Common Law Partner

31. Please provide full details of your spouse or Common Law Partner's work experience.

1. Work experience

Dates of Employment:	From To
Employing Company:
Job Title:
Skills used / Responsibilities:
Country:

2. Work experience

Dates of Employment:	From To
Employing Company:
Job Title:
Skills used / Responsibilities:
Country:

3. Work experience

Dates of Employment:	From To
Employing Company:
Job Title:
Skills used / Responsibilities:
Country:

32. Please provide full details of your spouse or Common Law Partner's educational qualifications.

1. Qualification

Dates of study:	From To
University/ College/School:
Subject:
Qualification:
Country:

2. Qualification

Dates of study:	From To
University/ College/School:
Subject:
Qualification:
Country:

3. Qualification

Dates of study:	From To
University/ College/School:
Subject:
Qualification:
Country:

33. How did you find us?

If you can provide further details on how you found us such as the actual name of a search engine, or which site linked to us, etc that would be useful.

34. FEEDBACK - Please provide any additional information that you think might help us evaluate your situation. Any comments on improvements that can be made to this form and other parts of our web-site are welcome:

Canada immigration :

Individuals

Employers

IT professionals

Business

Working holiday

Application forms :

Individuals

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