Assessment Form

Full Name

Age

Date of Birth

Email

Phone With Country Code

Skype Account

Country of Birth

Residential Address

Type of Immigration Services Requested

Marital Status

Number of Children Under 22 Years Old

Number of Children Over 22 Years Old

Highest Level of Education

Total number of Years of Education

Current Employment

Number of Years In Current Employment

English language skills: Y/N?

Yes No

French language skills: Y/N?

Yes No

Have you taken language ability test?

Yes No

Do you have relatives living in Canada?

Yes No

Available Funds To Settle In Canada in $CAN dollars.

What Is Your Net Worth in $CAN dollars.

Preferred Province of Settlement

Have you ever been charged or convicted of a criminal offence in any country?

Yes No

How did you hear about us?