Immigration-Canada.org - Free Immigration Assessment Form

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Immigration Approval Process

Free Immigration Assessment

Free, Confidential Assessment Page

Your data will remain confidential and will not be shared to any other company without permission.

Required fields are marked by: *

Personal Information

Title		Gender *
First Name *		Date of Birth *
Middle Initial		Country of Birth
Last Name *		Citizenship *
		Marital Status

Contact Information

Street Address		Email Address *
City		Home Phone # *
State/Province		Office Phone #
Country		Mobile Phone #
Zip/Postal Code		Fax #

Dependants

#	First Name	Family Name	Age	Sex	Relationship
1
2
3
4
5
6
7

Sponsorship

Do you intend to move to Canada: *

Do you have a close relative, spouse, or common law partner who can sponsor you?

If you are being sponsored, please provide details of your sponsor: * (only required if you have a sponsor)

First Name of Sponsor	Last Name of Sponsor	Age	Sex	Sponsor's Annual Income	Relationship to You

Education and Language

Your Highest Education Achievement:

Field of Study (if Applicable):

What official Canadian language are you most comfortable using?

English and French language ability:

	Speak	Read	Write	Understand
English
French

Work Experience

Please note the Work Experience Requirements to immigrate to Canada.

Your work experience is: *

Current Employment

If you are currently employed, who is your current employer?

What is your current job title?

Arranged Employment

Do you have a permanent job offer in Canada? And will you be capable of, and likely to accept, carrying out the job? (One of the following situations must apply to your case) *

Name of the employer offering you a job in Canada:

Self Employment

Have you owned and operated a business in the past five years?

If yes, please provide details:

Company Name		Location		Type of Business

Number of Employees	Annual Sales US$	Your Equity (%)	Net Assets of Company	Net Income of Company

Adaptability

Your spouse's Highest Education Achievement:
Have you or your Spouse / Common-Law Partner studied in Canada?
Have you or your Spouse / Common-Law Partner worked in Canada?
Do you or your spouse have family who are Canadian citizens or Permanent Residents?
If you wish to study in Canada temporarily, please state for how long?
If you wish to work in Canada, please state for how long?
What is your Net Worth (Value of Your Assets - Debts) in US$ *

General Questions

Have you or your spouse or any of your dependants:
	Ever had a serious disease or mental disorder or other health problem?
	Ever been convicted of any crime or offence in any country?
	Are you currently charged with any crime or offence in any country?
	Ever applied previously for temporary status in Canada (i.e. visitor/student/worker)?
	Ever been refused entry to Canada or ordered to leave Canada?
	Ever applied for permanent residence in Canada in the past?
	Ever been refused a Canadian visa (visitor, student, worker)?

I certify that to the best of my knowledge, the information I have furnished is true and correct. I understand that the above information will be kept confidential and is furnished to enable my status to be professionally assessed without charge.