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   Free Skilled Worker Assessment Questionnaire
Complete the following questionnaire to receive a free assessment of your qualifications for Canadian permanent residence as a Skilled Worker applicant.
Personal Information
Name:
Email Address:
In order to receive a reply, kindly ensure that you have sufficient space in your e-mail account. In addition, for Hotmail and Yahoo users our reply may be filtered as "Junk Mail".
Nationality:
Current Place of Residence: (City,Country)
Daytime Telephone number preceded by the area code: (areacode , phone number) Home, Office, or Mobile
Date of Birth:
Day        Month             Year
Sex:
Marital Status :
If Married, please provide Spouse's Characteristics in the fields below
Spouse's Date of Birth:
Day        Month             Year
Spouse's Level of Education and duration:
(If other please specify)
Spouse's total years of education: (Starting from primary school)

Spouse's field of study:


Spouse's Number of Years and Months of Working Experience:

Language Ability in French:
Number of Dependant Children:
Ability in English and French
English
Read
Write
Speak
Listen
French
Read
Write
Speak
Listen
Educational Profile
Total Years of education:
(Including Primary, Secondary, and Post Secondary)
1. Certificate:

(If other please specify)
Field of Study:
Date Started: (Month, Year)
Date of Graduation: (Month, Year)
Name of Institution:
City:
Country:

2. Certificate:

(If other please specify)
Field of Study:
Date Started: (Month, Year)
Date of Graduation: (Month, Year)
Name of Institution:
City:
Country:

3. Certificate:

(If other please specify)
Field of Study:
Date Started: (Month, Year)
Date of Graduation: (Month, Year)
Name of Institution:
City:
Country:
Employment History
1. Name of Company/Organization:
Job Title:
From: (Month, Year)
To: (Month, Year)
Employment Status:
Number of Hours Worked per Week: Hours per Week
Do You Presently Still Work at this Company? (Yes/No):
Employment Duties:

(please provide details)

City:
Country:

2. Name of Company/Organization:
Job Title:
From: (Month, Year)
To: (Month, Year)
Employment Status:
Number of Hours Worked per Week: Hours per Week
Do You Presently Still Work at this Company? (Yes/No):
Employment Duties:

(please provide details)

City:
Country:

3. Name of Company/Organization:
Job Title:
From: (Month, Year)
To: (Month, Year)
Employment Status:
Number of Hours Worked per Week: Hours per Week
Do You Presently Still Work at this Company? (Yes/No):
Employment Duties:

(please provide details)

City:
Country:
If you have additional experience, please include in the Additional Comments below.
Other
Relationship to Closest Blood Relative in Canada (Canadian Citizen or Landed Immigrant):
Blood Parent Blood Aunt/Uncle Blood Brother or Sister Blood Son/Daughter

Blood Niece/Nephew (22 years or older) Blood Grand Parent Blood Cousin

Relative Province of Residence :
Personal Net worth (CAD$):
Do you currently have an offer of employment from a Canadian employer?
If your answer to the above question is "Yes" provide details here:

Have you or spouse/common law partner or dependent children ever:
  • Had any serious disease
  • Been convicted of or currently charged with any crime or offence in any country
  • Applied previously for an immigrant visa to Canada
  • Visited Canada (visit,study,work)
Are you able to obtain a visitors visa to Canada
If answer to any of above is "Yes" provide details here:

PLEASE INFORM US HOW YOU WERE INTRODUCED TO THIS SITE:
Search Engine (please specify name & keywords used for the search)
Newspaper or Magazine (please specify)
Newsgroup (please specify)
General Recommendation
Additional Comments if Any:
 
 
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