General Immigration Assessment Form

Express Entry and Provincial Nomination Programs Assessment Form

First Name*

Last Name*

Email Address*

Telephone*

Home Address*

Nationality*

PERSONAL PROFILE:

Age*

Marital Status*

Country of Residence

Preferred Destination in Canada

LANGUAGE SKILLS:

English

Have you taken the IELTS test?

YesNo

Select the score below. If you haven't taken a test, please guess.

Speaking

----7.5 - 97.06.56.05.04.0 - 4.50 - 3.5

Reading

----8 - 97.0 - 7.56.56.05.04.0 - 4.50 - 3.5

Writing

----7.5 - 97.06.56.05.04.0 - 4.50 - 3.5

Listening

----8.5 - 98.07.0 - 7.56.56.0 - 75.0 - 5.54.0 - 4.50 - 3.5

French

Have you taken the TEF test?

YesNo

If yes, select the score below. If no, please guess if you speak French.

Speaking

----393 - 450371 - 392349 - 370310 - 348271 - 309226 - 270181 - 2250 - 180

Reading

----393 - 450371 - 392349 - 370310 - 348271 - 309226 - 270181 - 2280 - 180

Writing

----393 - 450371 - 392349 - 370310 - 348271 - 309226 - 270181 - 2250 - 180

Listening

----393 - 450371 - 392349 - 370310 - 348271 - 309226 - 270181 - 2250 - 180

What other languages do you speak?

EDUCATION AND TRAINING:

Highest level of education

Total years of education

Do you have a Canadian equivalency degree?

YesNo

If yes, title of equivalent degree

Any training (other than education)?

WORK HISTORY:

# of years paid work outside of Canada in the last 10 years

Job title

# of years paid work in Canada in a skilled occupation

Job title

JOB OFFER:

Do you have a written job offer from a Canadian employer?

If yes, job title

Name of the company and province

SPOUSE AND DEPENDENTS (If applicable):

How old is your spouse?

What is the highest level of education of your spouse?

Your Spouse's English Language Proficiency

Speaking

----7.5 - 97.06.56.05.55.04.0 - 4.50 - 3.5

Reading

----8 - 97.0 - 7.56.56.05.0 - 5.54.0 - 4.50 - 3.5

Writing

----7.5 - 97.06.56.05.04.0 - 4.50 - 3.5

Listening

----8.5 - 98.07.56.0 - 75.55.04.50 - 4

How many dependent children do you have?

FAMILY AND FRIENDS IN CANADA:

Do you have any family members or relatives in Canada?

If yes, relationship

Which province are they living in?

PERSONAL NET WORTH:

Net Worth (in Canadian dollars)

Ability to bring funds to Canada

ADMISSIBILITY:

Have you or your spouse been convicted of a crime?

Do you or your spouse have a serious health problem?

Who referred you to contact us?

Additional Notes

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