Free Assessment Questionnaire

Assessment Questionnaire For Permanent Residence In Canada

Complete the following questionnaire to receive a free assessment

My surname (family name):

My first name:

My other name:

Sex: Male       Female
My date of birth (ddmmyy):

My current mailing address:

My e-mail address:

My present marital status :

   SINGLE MARRIED

   LIVING COMMON-LAW*

*According to the Government of Canada Immigration Regulations "common-law partner" means, in relation to a person, an individual who is cohabiting with the person in a conjugal relationship, having so cohabited for a period of at least one year.
The term "Partner" is used in this questionnaire to represent the above person, if applicable.

My Education(Enter number of years successfully completed)

Elementary/primary school:

Secondary/high school:

University/college:

Formal apprenticeship/training:

Details of my post secondary education:

FROM (month/year)

TO (month/year)

Name of institution(including apprenticeship training)

Type of certificate or diploma issued:

FROM (month/year)

TO (month/year)

Name of institution(including apprenticeship training)

Type of certificate or diploma issued:

FROM (month/year)

TO (month/year)

Name of institution(including apprenticeship training)

Type of certificate or diploma issued:

FROM (month/year)

TO (month/year)

Name of institution(including apprenticeship training)

Type of certificate or diploma issued:

My ability in English (Select the appropriate proficiency for each one)

Speak:

Listen:

Read:

Write:

My ability in French (Select the appropriate proficiency for each one)

Speak:

Listen:

Read:

Write:

My present occupation is:

My work history for the past 10 years:

Date: FROM (month/year)

      TO (month/year)

My occupation:

Date: FROM (month/year)

       TO (month/year)

My occupation:

Date: FROM (month/year)

       TO (month/year)

My occupation:

Date: FROM (month/year)

       TO (month/year)

My occupation:

Do you have a relative residing in Canada who is a permanent resident of Canada or a Canadian Citizen?

Relationship to you of person listed above:

If single, please skip the following and click the Submit button at the end.
If married or in a common-law relationship, please fill in the following form, then click Submit button

My spouse's/partner's name:

My spouse's/partner's date of birth(dd/mm/yy):

My spouse/partner to accompany me to Canada: Yes No

My spouse's/partner's Education(Enter number of years successfully completed)

Elementary/primary school:

Secondary/high school:

University/college:

Formal apprenticeship/training:

Details of my spouse's/partner's post secondary education:

FROM (month/year)

     TO (month/year)

Name of institution(including apprenticeship training)

Type of certificate or diploma issued:

FROM (month/year)

     TO (month/year)

Name of institution(including apprenticeship training)

Type of certificate or diploma issued:

FROM (month/year)

TO (month/year)

Name of institution(including apprenticeship training)

Type of certificate or diploma issued:

FROM (month/year)

TO (month/year)

Name of institution(including apprenticeship training)

Type of certificate or diploma issued:

My spouse's/partner's ability in English (Select the appropriate proficiency for each one)

Speak:

Listen:

Read:

Write:

My spouse's/partner's ability in French (Select the appropriate proficiency for each one)

Speak:

Listen:

Read:

Write:

My spouse's/partner's present occupation:

My spouse's/partner's work history for the past 10 years:

Date: FROM (month/year)

      TO (month/year)

Occupation:

Date: FROM (month/year)

      TO (month/year)

Occupation:

Date: FROM (month/year)

      TO (month/year)

Occupation:

Date: FROM (month/year)

      TO (month/year)

Occupation:

Does your spouse/partner have a relative residing in Canada who is a permanent resident of Canada or a Canadian Citizen?

Relationship to spouse/partner of person listed above: