| Last Name |
|
| Name |
|
| Sex |
Male
Female |
| Date of Birth |
Month: Year: |
| Citizenship |
|
| Marital Status |
Married
Never
Was Married
Legally
Separated
Divorced
Widow/
er |
| Number of Children |
|
| Age of Children |
#1:
#2:
#3:
#4:
#5:
#6: |
| Highest Level of Education |
Secondary School
College
University |
| Post Secondary Education
Details:
|
| University/College: |
|
| Entered In: |
|
| Graduated In: |
|
| Full Time Program: By Correspondence: |
Type of Diploma and
Occupation As In Diploma:
*Specify
the department which issued your degree. For example, do not just
indicate that you received a B.Sc.; indicate which department issued
the B.Sc. (i.e., B.Sc. Computer Science). If you had a minor, or
double major, indicate both. If the level of degree does not use
standard terminology (i.e., Bachelor, Master, PhD or Doctorate),
indicate the equivalence of the degree.*
Enter the number of years of full time
studies you did
taking into consideration that
Full-time
studies:
At least 15 hours of instruction per week during the
academic year, including any period of training in the workplace that
forms part of the course of instruction.
|
Occupational History.
*Organization/s;
name/s; location/s; from month/year - to month/year; part time/full
time; position (s) held; duties. Providing little information will
result in an inaccurate assessment.
You must have at least one year’s full-time
work
in the past 10
years or
part-time equivalent work experience
in one or two
occupations
listed in
the NOC . full time works means 37.5 hours /week
|
| Language Ability
(English) Speak:
High proficiency:
Moderate
Basic
No
Read: : High proficiency Moderate
Basic No
Write ; High proficiency
Moderate
Basic: No
listen: High proficiency
Moderate
Basic No |
|
Language Ability
(French):
Speak: : High proficiency:
Moderate
Basic No
Read: High proficiency
Moderate
Basic No
Write: High proficiency Moderate
Basic No
listen: High proficiency Moderate
Basic No |
|
Please, provide below your spouse's personal data (if
applicable).
|
|
Last Name |
|
|
Name |
|
|
Date of Birth |
Month: Year: |
|
Citizenship |
|
|
Highest Level of Education |
Secondary School
College
University |
| Post Secondary Education
Details:
|
| University/College: |
|
| Entered In: |
|
| Graduated In: |
|
| Full Time Program: By Correspondence: |
Type of Diploma and
Occupation As In Diploma:
*Specify
the department which issued your degree. For example, do not just
indicate that you received a B.Sc.; indicate which department issued
the B.Sc. (i.e., B.Sc. Computer Science). If you had a minor, or
double major, indicate both. If the level of degree does not use
standard terminology (i.e., Bachelor, Master, PhD or Doctorate),
indicate the equivalence of the degree.*
|
Occupational History
*Organization/s;
name/s; location/s; from month/year - to month/year; part time/full
time; position (s) held; duties. Providing little information will
result in an inaccurate assessment.
|
Language Ability
(English):
Speak1:
High proficiency:
Moderate
Basic
No
Read1:
High proficiency:
Moderate
Basic
No
Write1:
High proficiency:
Moderate
Basic
No
listen1: High proficiency
Moderate
Basic No |
Language Ability
(French):
Speak1:
High proficiency:
Moderate
Basic
No
Read1:
High proficiency:
Moderate
Basic
No
Write1:
High proficiency:
Moderate
Basic
No
listen1: High proficiency
Moderate
Basic No |
Relatives in Canada with citizenship or permanent residence (yours
or your accompanying spouse)Father, mother, son, daughter, sister , Brother, grandparent,
uncle, aunt, niece, nephew, grandchild)
Yes: No:
If "yes", please, provide details:
|
Have you, your spouse
and dependents any serious
disease or physical or mental disorder?
Yes: No :
If "yes", please, provide details:
|
Have you, your spouse
and dependents been convicted of or currently charged with a crime or offence in
any country?
Yes: No :
If "yes", please, provide details:
|
Have you or your husband
been refused refugee status in, or an immigrant or visitor visa to,
Canada or any other country?
Yes: No :
If «yes», please, provide details:
|
Have you or your spouse
been refused admission to, or ordered to leave, Canada or any other
country?
Yes: No :
If «yes», please, provide details:
|
|
Have you or your spouse
funds to settle in Canada? ( Please see table in the Establishment
fund page). Yes:
No: |
|
Have you min 1 year full time authorized work in Canada
)? YesNo
|
|
Have you min 2 years full time post-secondary study in Canada) ? YesNo
|
|
Have you an informal job offer in Canada in keeping with past experience or education? yesNo
|
|
Have you Arranged Employment in Canada validated by HRDC YesNo
|
Insert your e-mail
address. Please, provide only one email address.
|
The assessment result will be sent to you by e-mail. Please make
sure that the address you provided is correct. An automated
receipt will be emailed to the address you have indicated above. If
you do not receive such a receipt, you may expect that the email
address is invalid. We will be unable to provide your assessment
result to you. |
|
|
|
