Personal information First Name: Last Name: E-mail: Phone: Age: Country of residence: ---AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua & DepsArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia HerzegovinaBotswanaBrazilBruneiBulgariaBurkinaBurundiCambodiaCameroonCanadaCape VerdeCentral African RepChadChileChinaColombiaComorosCongoCongo {Democratic Rep}Costa RicaCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIreland {Republic}IsraelItalyIvory CoastJamaicaJapanJordanKazakhstanKenyaKiribatiKorea NorthKorea SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmar, {Burma}NamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussian FederationRwandaSt Kitts & NevisSt LuciaSaint Vincent & the GrenadinesSamoaSan MarinoSao Tome & PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth SudanSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabwe Marital status: SingleMarriedWidowedCommon-Law Do you have dependent children and if yes how many?: Nationality: ---AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua & DepsArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia HerzegovinaBotswanaBrazilBruneiBulgariaBurkinaBurundiCambodiaCameroonCanadaCape VerdeCentral African RepChadChileChinaColombiaComorosCongoCongo {Democratic Rep}Costa RicaCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIreland {Republic}IsraelItalyIvory CoastJamaicaJapanJordanKazakhstanKenyaKiribatiKorea NorthKorea SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmar, {Burma}NamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussian FederationRwandaSt Kitts & NevisSt LuciaSaint Vincent & the GrenadinesSamoaSan MarinoSao Tome & PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth SudanSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabwe Do you have a passport? YesNo Expiration date Nationality: ---AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua & DepsArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia HerzegovinaBotswanaBrazilBruneiBulgariaBurkinaBurundiCambodiaCameroonCanadaCape VerdeCentral African RepChadChileChinaColombiaComorosCongoCongo {Democratic Rep}Costa RicaCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIreland {Republic}IsraelItalyIvory CoastJamaicaJapanJordanKazakhstanKenyaKiribatiKorea NorthKorea SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmar, {Burma}NamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussian FederationRwandaSt Kitts & NevisSt LuciaSaint Vincent & the GrenadinesSamoaSan MarinoSao Tome & PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth SudanSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabwe Do you have a passport? YesNo Expiration date Nationality: ---AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua & DepsArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia HerzegovinaBotswanaBrazilBruneiBulgariaBurkinaBurundiCambodiaCameroonCanadaCape VerdeCentral African RepChadChileChinaColombiaComorosCongoCongo {Democratic Rep}Costa RicaCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIreland {Republic}IsraelItalyIvory CoastJamaicaJapanJordanKazakhstanKenyaKiribatiKorea NorthKorea SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmar, {Burma}NamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussian FederationRwandaSt Kitts & NevisSt LuciaSaint Vincent & the GrenadinesSamoaSan MarinoSao Tome & PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth SudanSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabwe Do you have a passport? YesNo Expiration date Knowledge of Canadian Official Languages Have you taken the English language exam in the last 2 years? YesNo What language exam did you take? IELTS GeneralCELPIP-G What score did you get? Listening ---4.04.55.05.56.06.57.07.58.08.59.0 Reading ---4.04.55.05.56.06.57.07.58.08.59.0 Writing ---4.04.55.05.56.06.57.07.58.08.59.0 Speaking ---4.04.55.05.56.06.57.07.58.08.59.0 What score did you get? Listening ---less than 55678910-12 Reading ---less than 55678910-12 Writing ---less than 55678910-12 Speaking ---less than 55678910-12 Have you taken the French language exam in the last 2 years? YesNo What language exam did you take? TEF CanadaTCF Canada What score did you get? Listening ---145-180181-216217-248249-279280-297298+ Reading ---121-150151-180181-206207-232233-247248+ Writing ---349-370310-348271-309226-270181-225371+ Speaking ---181-225226-270271-309310-348349-370371+ What score did you get? Listening ---331-368369-397398-457458-502503-522523-548549-699 Reading ---342-374375-405406-452453-498499-523524-548549-699 Writing ---4-567-910-1112-1314-1516-20 Speaking ---4-567-910-1112-1314-1516-20 What is your level of English? Listening ---None at allElementaryIntermediateAdvancedProficiency Reading ---None at allElementaryIntermediateAdvancedProficiency Writing ---None at allElementaryIntermediateAdvancedProficiency Speaking ---None at allElementaryIntermediateAdvancedProficiency What is your level of French? Listening ---None at allElementaryIntermediateAdvancedProficiency Reading ---None at allElementaryIntermediateAdvancedProficiency Writing ---None at allElementaryIntermediateAdvancedProficiency Speaking ---None at allElementaryIntermediateAdvancedProficiency Education What is your level of education? (List all your education history) Did you get this education in Canada? Junior High SchoolHigh SchoolOne-year Post-secondary ProgramTwo-years Post-secondary ProgramBachelor's DegreeMaster's DegreePh.D. - Choose a Program Duration * -1 year2 years3 years4 years5 years and more YesNo -+ Work experience What is your profession / primary occupation? How many years of skilled work experience do you have? How many years?None1 year2 years3 years or more -+ Do you have Canadian Work Experience YesNo What is your profession / primary occupation? How many years of Canadian work experience do you have? ---None1 year2 years3 years4 years5 years or more -+ Have you received a written job offer from a Canadian employer? YesNo Occupation Province ---AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaOntarioPrince Edward IslandQuebecSaskatchewanYukonNunavutNorthwest Territories Duration of your contract ---Less Than 6 Months6 months1 year or longer How many hours per week you will work? Is your job offer supported by a Labour Market Impact Assessment (LMIA)? YesNo Other Personal Information Family in Canada Do you or your spouse/common-law partner have any family members or relatives (parents and siblings only) living in Canada? YesNo Your personal Net Worth Choose currency Canadian DollarsUS DollarsEuro Amount 10.000-15.00015.000-20.00020.000-25.00025.000-50.00050.000-100.000100.000-250.000250.000-500.000 Spouse/Common-law Partner Information What is the highest level of education of your Spouse/Common-Law Partner? ---Junior High SchoolHigh SchoolOne-year Post-secondary ProgramTwo-years Post-secondary ProgramBachelor's DegreeMaster's DegreePh.D. How many years of CANADIAN work experience does your Spouse/Common-Law Partner have within the last ten years? ---None1 year2 years3 years4 years5 years or more Have your spouse taken the English language exam in the last 2 years? YesNo What language exam did he/she take? IELTS GeneralCELPIP-G What score did he/she get? Listening ---4.04.55.05.56.06.57.07.58.08.59.0 Reading ---4.04.55.05.56.06.57.07.58.08.59.0 Writing ---4.04.55.05.56.06.57.07.58.08.59.0 Speaking ---4.04.55.05.56.06.57.07.58.08.59.0 What score did he/she get? Listening ---less than 55678910-12 Reading ---less than 55678910-12 Writing ---less than 55678910-12 Speaking ---less than 55678910-12 Have your spouse taken the French language exam in the last 2 years? YesNo What language exam did he/she take? TEF CanadaTCF Canada What score did he/she get? Listening ---145-180181-216217-248249-279280-297298+ Reading ---121-150151-180181-206207-232233-247248+ Writing ---349-370310-348271-309226-270181-225371+ Speaking ---181-225226-270271-309310-348349-370371+ What score did he/she get? Listening ---331-368369-397398-457458-502503-522523-548549-699 Reading ---342-374375-405406-452453-498499-523524-548549-699 Writing ---4-567-910-1112-1314-1516-20 Speaking ---4-567-910-1112-1314-1516-20 What is your spouse's level of English? Listening ---None at allElementaryIntermediateAdvancedProficiency Reading ---None at allElementaryIntermediateAdvancedProficiency Writing ---None at allElementaryIntermediateAdvancedProficiency Speaking ---None at allElementaryIntermediateAdvancedProficiency What is your spouse's level of French? Listening ---None at allElementaryIntermediateAdvancedProficiency Reading ---None at allElementaryIntermediateAdvancedProficiency Writing ---None at allElementaryIntermediateAdvancedProficiency Speaking ---None at allElementaryIntermediateAdvancedProficiency Additional information Please provide any additional information that you think would be relevant to your immigration assessment. At what stage of decision making are you? ---Ready to start my applicationJust gathering information When do you plan to start your application? ---ImmediatelyIn the next 3 monthsIn 6-12 monthsI'm not planning yet What is the best way to approach you? EmailSkypeWhatsAppPhone call
