Assessment Form

Please complete the form below to the best of your ability to obtain a more accurate assessment of your chances to visit, study, or work in Canada. This form can only be filled out electronically.

Before you go any further...


Temporary Visit
For Work
For Studying
To migrate (live in Canada)

General Information

*Required

Male Female

Single
Married
Divorced
Widowed
Yes No
Yes No

Criminality (if applicable)


Yes
No

Associations (if applicable)


Yes
No



Education (if applicable)


High School
Trade School
Vocational School
University College

This includes Elementary School, Secondary/High School, University/College, Trade School, and other post-secondary schools.


Language Skills


Excellent Very Good Good N/A
Excellent Very Good Good N/A
Excellent Very Good Good N/A
Excellent Very Good Good N/A
Yes No





Excellent Very Good Good N/A
Excellent Very Good Good N/A
Excellent Very Good Good N/A
Excellent Very Good Good N/A

Residency

Please provide all information for places you have resided for the past 10 years, without gaps.

















Work Experience (if applicable)

Please complete your work experience in full for the last 10 years:


















Spousal Information (if applicable)

Male Female

Spouse's Education (if applicable)


High School
Trade School
Vocational School
University College

This includes Elementary School, Secondary/High School, University/College, Trade School, and other post-secondary schools.

Spouse's Work Experience (if applicable)

Please complete your spouse's work experience in full for the last 10 years:


















Children (if applicable)

Yes No
Male Female
Male Female

Arranged Employment


Yes - fill out additional information.
No


Relatives in Canada


Yes
No

Previous Work or Study in Canada

Yes
No


Last Questions...


If you have anything additional that you feel we should know, or if you simply have something you'd like to tell us - please include it here.


In-Person
Skype
Phone

Internet Search
CICS News
Newspaper Advertisement
Referral:
Other:

Note

We urge all our clients and prospective clients to use the Internet and the ICCRC website to research and check us and any representative that you may think of employing, for your own protection. Many "ghost" representatives promote their services to unsuspecting clients and are not qualified or Regulated Canadian Immigration Consultants but are in fact just middle men asking for referral fees. Please be sure to check anyone and everyone you deal with is an accredited member of the ICCRC.