Assessment Business Class

Family Name:

First Name:

Age in Years:

Gender:

Male

Female

Nationality:

Date of Birth (DD/MM/YYYY):

Current Address:

Marital Status:

No. of Children:

Age of Children (in years):

Country:

E-mail Address:

Re-enter E-mail Address:

Work Phone (with area code):

Mobile (Cell) Phone:

Highest level completed:

University:

Trade or non-university certificate or diploma:

Name of High School, University or Trade School:

Total Work Experience (in years):

Do you have a job offer in Canada which is approved by HRDC?

Yes

No

Do you have minimum of one year work experience in Canada?

Yes

No

Do you have minimum of two years study experience in Canada?

Yes

No

Do you or your accompanying spouse have a family member in Canada?

Yes

No

Have you ever had problem with the law or imprisoned for political or criminal reasons?

Yes

No

Have you been refused admission to, or ordered to leave Canada or any other country?

Yes

No

Family Name:

First Name:

No. of Children:

How old are they? (in years)

If over 22 are they student?

Yes

No

Knowledge of English or French:

Spouse's Nationality

Spouse's Education:

General or Express Entry category assessment

Scholar Immigration