ASSESSMENT FORM

Applicant's Name *

First

Last

Age *

Email *

Phone *

Education (school/ university- program- level of education- year of graduation) *

Work Experience (occupation- number of years- job description) *

English Level

IELTS/ CELPIP Score *

Reading - Writing - Listening - Speaking

French Level

TEF/ TCF Score *

Reading - Writing - Listening - Speaking

Marital Status

Dependents (relation and age)

Employment Insurance

If Yes, for how long?

Medical Condition

If Yes, explain

Have you ever committed, been arrested for, or been charged with or convicted of any criminal offence in any country or territory?

If Yes, explain

Have you ever been refused entry to Canada?

If Yes, provide the date and type of application

Schengen Visa

If Yes, indicate where and when

Financial statement of available fund (in Canadian dollar)

Hard assets such as

If Yes, indicate the value

Information of Spouse *

First

Last

Age *

Spouse's Education (school/ university- program- level of education- year of graduation) *

Spouse's Work Experience (occupation- number of years- job description) *

Spouse's English Level

Spouse's IELTS/ CELPIP Score *

Reading - Writing - Listening - Speaking

Spouse's French Level

Spouse's TEF/ TCF Score *

Reading - Writing - Listening - Speaking

Spouse's Employment Insurance

If Yes, for how long?