Assessment FormTo assess your eligibility to immigrate to Canada as a skilled worker, kindly fill out the questionnaire below and then book an Appointment: (Please write N/A next to any question that is not applicable)Your Given Name *Your Family Name *Email Address *Phone Number *Street Address *Apartment, suite, etcCityState/ProvinceZIP / Postal CodeCountry AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaAustraliaArubaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCabo VerdeCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGuernseyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSaint HelenaSaint Pierre & MiquelonSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUS Minor Outlying IslandsUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemen Arab Rep.Yemen DemocraticZambiaZimbabweDate of Birth *Marital Status *SingleMarriedCommon-lawOtherCountry of Citizenship *Country of Residence *What is your highest level of Education? *What is your field of study? *Which educational institute issued your highest educational certificate? *Insert name of univ/college/school and name of city/countryWhat is your job title/description? *What are your job duties? How many years of work experience do you have in the last 10 years? *Please select an option0123456 or moreHave you taken a language test, in either English or French, within the last two (2) years?YesNoIf not, kindly indicate an estimate of your language skills belowWhich language test did you take? *If you have NOT taken a language test, provide an estimate of your language levels for all 4 skills below - Speaking:Listening:Reading:Writing:Do you speak French as a first or second language?YesNoPlease indicate all other languages you speak.Do you have a job offer from an employer in Canada? (Full Time and for at least 1 year)YesNoHave you previously studied in Canada for at least 2 years, or worked in Canada for at least 1 year full time?YesNoDo you or your spouse have any parents/grandparents/siblings/children/grandchildren/nephews/nieces in Canada?YesNoDo you have a spouse/common law partner that will be accompanying you to Canada?YesNoWhat is your spouse's Given Name? *What is your spouse's Last Name? *What is your spouse's date of birth?What is your spouse’s highest level of Education? *What is your spouse’s field of study? *Which educational institute issued your spouse's highest educational certificate?Insert name of univ/college/school and name of city/countryWhat is your spouse’s job title/description? *Mention 'Job Title' and a description of job duties How many years of work experience does your spouse have in the last 10 years? *Please select an option0123456 or moreHas your spouse taken a language test, in either English or French, within the last two (2) years?YesNoIf not, kindly indicate an estimate of your spouse's language skills belowWhich language test did your spouse take?If your spouse has NOT taken a language test, provide an estimate of their language levels for all 4 skills - Speaking:Listening:Reading:Writing:Does your spouse have a second language?YesNoPlease indicate all other languages your spouse speaks• Does your spouse have a job offer from an employer in Canada? (Full Time and for at least 1 year) YesNoHas your spouse previously studied in Canada for at least 2 years, or worked in Canada for at least 1 year full time?YesNoDo you have any further information to add?Submit
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