FREE IMMIGRATION ASSESSMENT

Complete the following questionnaire to receive a free assessment of your qualifications for Job and work permit or Canadian permanent residence.

Personal Information
First Name : *		Last Name *
Email : *		Address : *
City : *		State : *
Country : *	Select Country Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia Botswana Bouvet Island Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos Islands Columbia Comoros Congo Cook Islands Costa Rica Cote D'Ivoire Croatia Cuba Cyprus Czech Republic Korea Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador England Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea Kuwait Kyrgyzstan Lao Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Mariana Islands Mauritius Mexico Mongolia Morocco Mozambique Myanmar Namibia Nepal Netherlands New Caledonia New Zealand Nicaragua Nigeria Norfolk Island Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Qatar Romania Russia San Marino Sao Tome Saudi Arabia Scotland Senegal Seychelles Sierra Leone Singapore Slovak Republic Slovenia Solomon Islands Somalia South Africa South Georgia Spain Sri Lanka Saint Helena Sudan Sweden Switzerland Syria Taiwan Region Tajikistan Tanzania Thailand Trinidad & Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vatican City Venezuela Vietnam Virgin Islands (Brit) Virgin Islands (US) wales Wallis&Futuna Islands Western Sahara Yemen Yugoslavia Zaire Zambia Zimbabwe	Phone Number : *
Nationality: *		Age : *	Select Age 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70    Age Points 21-49 years of age Max 16 years of age or younger/54 year of age or older Zero
Sex : *	Select Sex Male Female	Marital Status : *	Select Marital Status Single Married Divorced/Separated

If Married, please provide Spouse's Characteristics
Spouse's Level of Education and duration	Select Spouse Education Secondary school 12 years of full-time studies 13 years of full-time studies 14 years of full-time studies 15 years of full-time studies 17 years of full-time studies	Number of Dependant Children

Language English and French *    To assess your English and French ability, first decide which language you are most comfortable with. This language is your first official language. The language you feel less comfortable communicating in is your second official language. First Official Language Speaking Listening Reading Writing High proficiency 4 4 4 4 Moderate proficiency 2 2 2 2 Basic proficiency 1 1 1 1 Please Note: You can score a maximum of only two points in total for basic-level proficiency. Not at all 0 0 0 0 Second Official Language Speaking Listening Reading Writing High proficiency 2 2 2 2 Moderate proficiency 2 2 2 2 Basic proficiency 1 1 1 1 Please Note: You can score a maximum of only two points in total for basic-level proficiency. Not at all 0 0 0 0

Reading Writing Speaking Listening First Language Select Option High proficiency Moderate proficiency Basic proficiency Not at all Select Option High proficiency Moderate proficiency Basic proficiency Not at all Select Option High proficiency Moderate proficiency Basic proficiency Not at all Select Option High proficiency Moderate proficiency Basic proficiency Not at all Second Language Select Option High proficiency Moderate proficiency Basic proficiency Not at all Select Option High proficiency Moderate proficiency Basic proficiency Not at all High proficiency Moderate proficiency Basic proficiency Not at all Select Option High proficiency Moderate proficiency Basic proficiency Not at all

Educational Profile    EDUCATIONAL CREDENTIALS MAXIMUM 25 POINTS Master's Degree or Ph.D. AND at least 17 years of full-time or full-time equivalent study. 25 Two or more university degrees at the bachelor's level AND at least 15 years of full-time or full-time equivalent study. 22 Three-year diploma, trade certificate or apprenticeship AND at least 15 years of full-time or full-time equivalent study. 22 Two-year university degree at the bachelor's level AND at least 14 years of full-time or full-time equivalent study. 20 Two-year diploma, trade certificate or apprenticeship AND at least 14 years of full-time or full-time equivalent study. 20 One-year university degree at the bachelor's level AND at least 13 years of full-time or full-time equivalent study. 15 One-year diploma, trade certificate or apprenticeship AND at least 13 years of full-time or full-time equivalent study. 15 One-year diploma, trade certificate or apprenticeship AND at least 12 years of full-time or full-time equivalent study. 12 Completed high school. 5
Total Years of education * (Starting from primary school)	Select Education Secondary school 12 years of full-time studies 13 years of full-time studies 14 years of full-time studies 15 years of full-time studies 17 years of full-time studies

Employment History
Job Title *	Select Job Title * Restaurant and Food Service Managers Primary Production Managers (Except Agriculture) Professional Occupations in Business Services to Management Insurance Adjusters and Claims Examiners Biologists and Related Scientists Architects Specialist Physicians General Practitioners and Family Physicians Dentists Pharmacists Physiotherapists Registered Nurses Medical Radiation Technologists Dental Hygienists & Dental Therapists Licensed Practical Nurses Psychologists Social Workers Chefs Cooks Contractors and Supervisors, Carpentry Trades Contractors and Supervisors, Mechanic Trades Electricians (Except Industrial & Power System) Industrial Electricians Plumbers Welders & Related Machine Operators Heavy-Duty Equipment Mechanics Crane Operators Drillers & Blasters - Surface Mining, Quarrying & Construction Supervisors, Oil and Gas Drilling and Service
Other Job Details
Total Years of working experience	Select Experience Less than 1 year 1 to 2 years 2 to 3 years 3 to 4 years 4 or more years    Years of Experience* POINTS One year 15 Two years 17 Three years 19 Four or more years 21
Others    Do not neglect to answer these questions as positive answers to any one of them could result in a positive assessment. When accounting for family members in Canada, use accurate terminology (i.e. ensure that the familial relationship to you or your spouse/partner is correct)
Worked full-time in Canada for at least one year? *	Select Option No Yes
Have You or Spouse Studies in Canada atleast two years *	Select Option No Yes
Relationship to Closest Blood Relative in Canada * (Canadian Citizen or Landed Immigrant)	Select Option No Brother Sister Uncle Aunt Niece Nephew Parent Child Grandparent
Do you currently have an offer of employment from a Canadian employer? *	Select Option No Yes
If your answer to the above question is "Yes" provide details here *
Have you or your spouse or common-law partner ever
Had any serious disease	Yes No
Been convicted of or currently charged with any crime or offence in any country	Yes No
Applied previously for an immigrant visa to Canada	Yes No
If answer to any of above is "Yes" provide details here
Additional Comments if Any *