Free Preliminary Canadian Immigration Assessment Form

To work, visit or study in Canada there are procedures which must be met and fees apply.

Please complete this form to the best of your ability. If a question is not applicable to you, write N/A.

The information collected in this form will be shared with our partner, a reputable Canadian Immigration Services firm, helping people just like you achieve their dream of visiting, living or working in our beautiful country, Canada. Rated Durham Region’s #1 top Immigration firm for a reason, offering personalized service and stay by your side every step of the way. They will review your information to determine which Canadian immigration programs you are currently eligible for. You will be contacted shortly.

Job Canada is here to help you! 32+ years' experience helping jobseekers & companies achieve goals!

Experts in assisting people in the Canadian market easily find Employment and Career Training, Resume Assistance, Employment specialists and more here to serve you since 2000!

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General Information First Name* Last Name* Email* Telephone Number* Country of Birth* Date of Birth*

Why do you want to come to Canada

Business / Entrepreneur

Class Investor

Entrepreneur

Family sponsorship

Self-Employed

Skilled Worker

Provincial Nominee Programs (PNP) Family Class

Student / Study Permit

Visitor Visa / Super Visa / Start-up Visa

Current Address Street* City* State/Province* Country* Postal Code*

Marital Status What is your current Marital Status?

Married

Widow/Widower

Single

Engaged

Common-Law

Divorce/Separated

If you are married, date married If you live with your spouse, but are not married, what is the day you started living together If you are married or common-law, will your spouse immigrate to Canada with you?

Yes

No

Do you have children?

Yes

No

How many children do you have? What are their ages?

TRAVEL TO CANADA Have you worked in, studied in, or visited Canada?

Yes

No

Have you ever had a work or study permit to Canada?

Yes

No

If you lived in Canada before what were the dates? From: To: Do you or your partner have close family members who are Permanent Residents or Citizens of Canada?

Yes

No

English Language Test Have you taken an IELTS or CELPIP English language test?

Yes

No

Test Date:

General

Academic

Reading Score Writing Score Speaking Score Listening Score

EDUCATION

Most Recent Education

From (YYYY-MM)* To (YYYY-MM)* Name of School* City and Country* Type of Degree* Area of Study*

Other Previous Education

From (YYYY-MM) To (YYYY-MM) Name of School City and Country Type of Degree Area of Study

EMPLOYMENT HISTORY

Most Recent Employment

From (YYYY-MM)* To (YYYY-MM) Job Title* City/Town and Country* Name of Employer* Was it work in Canada

Yes

No

Other Previous Employment

From (YYYY-MM) To (YYYY-MM) Job Title City and Country Name of Employer Was it work in Canada

Yes

No

TRAVEL FOR THE LAST 10 YEARS

*DO NOT INCLUDE TRIPS IN OR TO YOUR COUNTRY OF ORIGIN

Most Recent Trip Taken

From (YYYY-MM) To(YYYY-MM) City and Country Purpose of Trip Visa Issued

Yes

No

Other Previous Trip Taken

From (YYYY-MM) To(YYYY-MM) City and Country Purpose of Trip Visa Issued

Yes

No

ADDITIONAL QUESTIONS Have you or your spouse ever been convicted of or currently subject to any criminal proceeding in any country?

Yes

No

Previously sought refugee status in Canada or elsewhere?

Yes

No

Been refused admission to Canada OR any other country?

Yes

No

Had a serious disease or mental disorder?

Yes

No

How did you hear about us? If other please specify:

Attach your Resume* (Word or PDF format only)*: