Customized Assessment Form

Are you eligible to immigrate to Canada?

Personal Information
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email Address*
Phone*
Birthdate
Date Format: MM slash DD slash YYYY
Country of Citizenship

Professional Information
What is your profession?
Please list the duties and responsibilities you hold at your job in detail.
If there is a document describing your position and responsibilities, please attach it
File
File
How many years of job experience do you have?
Please enter a number from 1 to 50.
Have you ever changed careers? If the answer is no, skip the next question
List your previous professions, and how many years of experience you have at each job.
Attach your résumé or curriculum vitae.

Education
What is the highest level of education you have achieved?
How many years of education have you completed? Start counting from grade 1.
Please enter a number from 1 to 50.
Starting with your High School Diploma, attach copies of each of your degrees.
File
File
File
File
File

Language Skills
How is your command of the English language? Consider your grammatical skills, writing, reading, and speaking.
How is your command of the French language? Consider your grammatical skills, writing, reading, and speaking.
What is your marital status?
if you are single or married, please skip the next question.

Family
When did you and your partner start living together?
Date Format: MM slash DD slash YYYY
Do you have any children?
If so, how old are they? If your children are in school, please indicate the grade (class) and school they are attending.
Do you have any relatives, friends, or acquaintances that live in Canada?
If so, what is your relationship?
In the past, have you or your spouse attended school or worked in Canada?
What is the highest level of education your spouse or your live-in-partner has obtained?
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Questions geared towards creating solutions
Do you have an employment offer from a Canadian employer?
If so, please share their information and a copy of the employment offer.
In order to become a permanent resident, are you willing to study and graduate at a Canadian post-secondary institution?
If your answer is yes, what subject would you like to study?
Would you like to come to Canada as a small or medium business owner?
If your answer is yes, what is the minimum and maximum net amount you would be able to bring to Canada?

Questions regarding health restrictions and criminal convictions
Do you, your spouse, or any of your children have a medical condition requiring long-term care?
If so, please elaborate.
Do you, or a family member, require extra help due to a disability?
If so, please elaborate.
Do you, or any of your family members have a criminal record (including traffic offenses)?
If the answer is yes, please attach a copy of the court order.