Skilled-Worker Assessment Form Step 1 of 8 12% Contact InformationName* First Middle Last Email* Phone/WhatsApp*Your phone number, including the country code and area code.Age*Enter your ageUnder 1818192021222324252627282930313233343536373839404142434445464748495051525354555657585960 or olderHow did you hear about us?* Google Referral from School Referral from Friend/Family/Colleague Live Seminar Instagram Facebook Other Name of School Seminar Location Details Details Citizenship and ResidenceAre you currently inside Canada?* Yes No Country of Citizenship*Select your country of citizenshipCanadaRussiaUkraineMexicoUnited States of AmericaAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsThe country for which you hold a passport.Country of ResidenceSelect the country where you are currently livingCanadaOtherThe country where you are currently living.City of Residence The city where you are currently living.Your Canadian Immigration GoalYour Canadian Immigration Goal*Select your Canadian Immigration GoalI want to become a Permanent Resident/Citizen of CanadaI want to work in Canada temporarilyI want to study in CanadaI want to visit CanadaOther (please specify)Purpose of Visit Tourism Business Job Search Family Visit Conference Other Please select all that applyYour Immigration GoalHave you been accepted to a study program inside Canada? Yes No School and/or Program Please provide details on the program you have been accepted to.Preferred Destination in Canada (select up to 3) No Preference I'm Not Sure Alberta British Columbia Manitoba New Brunswick Newfoundland & Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Select the provinces and/or territories you are interested in immigrating to. Your Language SkillsDo you know any English?* Yes No English Level (Speaking)*Select your English Speaking levelAdvanced / Fluent (CLB 9+)Upper Intermediate (CLB 8)Intermediate (CLB 7)Lower Intermediate (CLB 5-6)Elementary (CLB 4)None at all - Beginner (CLB 1-3)How would you rate your English speaking level?English Level (Listening)*Select your English listening levelAdvanced / Fluent (CLB 9+)Upper Intermediate (CLB 8)Intermediate (CLB 7)Lower Intermediate (CLB 5-6)Elementary (CLB 4)None at all - Beginner (CLB 1-3)How would you rate your English listening level?English Level (Reading)*Select your English reading levelAdvanced / Fluent (CLB 9+)Upper Intermediate (CLB 8)Intermediate (CLB 7)Lower Intermediate (CLB 5-6)Elementary (CLB 4)None at all - Beginner (CLB 1-3)How would you rate your English reading level?English Level (Writing)*Select your English reading levelAdvanced / Fluent (CLB 9+)Upper Intermediate (CLB 8)Intermediate (CLB 7)Lower Intermediate (CLB 5-6)Elementary (CLB 4)None at all - Beginner (CLB 1-3)How would you rate your English writing level?Have you taken the IELTS General Training English exam?* Yes No Date of Your Test DD slash MM slash YYYY When did you write your IELTS exam?IELTS Score (Speaking)*Select your score98.587.576.565.554.543.532.5IELTS Score (Listening)*Select your score98.587.576.565.554.543.532.5IELTS Score (Reading)*Select your score98.587.576.565.554.543.532.5IELTS Score (Writing)*Select your score98.587.576.565.554.543.532.5Have you taken the CELPIP Exam? (Canadian English Language Proficiency Index Program)* Yes No Date of Your Test DD slash MM slash YYYY When did you write your CELPIP exam?CELPIP Score (Speaking)*Select your score1211109876543 or lessCELPIP Score (Listening)*Select your score1211109876543 or lessCELPIP Score (Reading)*Select your score1211109876543 or lessCELPIP Score (Writing)*Select your score1211109876543 or lessDo you know any French?* Yes No French Level (Speaking)*Select your French Speaking levelAdvanced / Fluent (CLB 9+)Upper Intermediate (CLB 8)Intermediate (CLB 7)Lower Intermediate (CLB 5-6)Elementary (CLB 4)None at all - Beginner (CLB 1-3)How would you rate your French speaking level?French Level (Listening)*Select your French listening levelAdvanced / Fluent (CLB 9+)Upper Intermediate (CLB 8)Intermediate (CLB 7)Lower Intermediate (CLB 5-6)Elementary (CLB 4)None at all - Beginner (CLB 1-3)How would you rate your French listening level?French Level (Reading)*Select your French reading levelAdvanced / Fluent (CLB 9+)Upper Intermediate (CLB 8)Intermediate (CLB 7)Lower Intermediate (CLB 5-6)Elementary (CLB 4)None at all - Beginner (CLB 1-3)How would you rate your French reading level?French Level (Writing)*Select your French reading levelAdvanced / Fluent (CLB 9+)Upper Intermediate (CLB 8)Intermediate (CLB 7)Lower Intermediate (CLB 5-6)Elementary (CLB 4)None at all - Beginner (CLB 1-3)How would you rate your French writing level?Additional Comments on your Language Abilities Your Education and TrainingHave you completed high school (secondary school)?* Yes No Have you received any education or training other than high school (secondary school)?* Yes No List all education programs you have completed.First ProgramType of Program*Select the type of programPhDMastersBachelorsCollege or Non-UniversityProfessional or VocationalApprenticeshipTrades CertificateAssociates DegreeOtherLength of Program*Select the length of the programLess than 3 monthsBetween 3 and 6 monthsBetween 6 months and 1 year1 academic year2 academic years3 academic years4 academic years or moreSubject of Study/Training Location of Program In what country did you complete this program?Did you complete this program?* Yes No Add a second program? (You should list all educational programs you have completed)* Yes No Second ProgramType of Program*Select the type of programPhDMastersBachelorsCollege or Non-UniversityProfessional or VocationalApprenticeshipTrades CertificateAssociates DegreeOtherLength of Program*Select the length of the programLess than 3 monthsBetween 3 and 6 monthsBetween 6 months and 1 year1 academic year2 academic years3 academic years4 academic years or moreSubject of Study/Training Location of Program In what country did you complete this program?Did you complete this program?* Yes No Add a third program? (You should list all educational programs you have completed)* Yes No Third ProgramType of Program*Select the type of programPhDMastersBachelorsCollege or Non-UniversityProfessional or VocationalApprenticeshipTrades CertificateAssociates DegreeOtherLength of Program*Select the length of the programLess than 3 monthsBetween 3 and 6 monthsBetween 6 months and 1 year1 academic year2 academic years3 academic years4 academic years or moreSubject of Study/Training Location of Program In what country did you complete this program?Did you complete this program?* Yes No Additional Comments on Your Education and Training Your Work HistoryHave you done any paid work in the last 10 years?* Yes No Job 1List all paid work you have done.Occupation Length of Work*Select the length of workless than 1 year1 year2 years3 years4 years5 years6 years or moreWhen did you finish this work?*Select when you finished this workI am currently working this jobLess than 1 year ago1 year ago2-9 years agoMore than 9 years agoWork Hours* Full Time (30 hours per week or more) Part Time (15 to 30 hours per week) Less than 15 hours per week Location* Inside Canada Outside Canada Add a second job?* Yes No You should list all paid work you have done in the past 10 yearsJob 2Occupation Length of Work*Select the length of workless than 1 year1 year2 years3 years4 years5 years6 years or moreWhen did you finish this work?*Select when you finished this workI am currently working this jobLess than 1 year ago1 year ago2-9 years agoMore than 9 years agoWork Hours* Full Time (30 hours per week or more) Part Time (15 to 30 hours per week) Less than 15 hours per week Location* Inside Canada Outside Canada Add a third job?* Yes No Job 3Occupation Length of Work*Select the length of workless than 1 year1 year2 years3 years4 years5 years6 years or moreWhen did you finish this work?*Select when you finished this workI am currently working this jobLess than 1 year ago1 year ago2-9 years agoMore than 9 years agoWork Hours* Full Time (30 hours per week or more) Part Time (15 to 30 hours per week) Less than 15 hours per week Location* Inside Canada Outside Canada Additional Comments on Your Work ExperienceCanadian Job OfferDo you have a written job offer from a Canadian employer?* Yes No Occupation of Job Offer LocationSelect the location of the job offerAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonWhat is the contract duration?* Less than 6 months Between 6 months and 1 year Between 1 and 2 years 2 years or longer Is the Job Offer supported by a Labour Market Impact Assessment (LMIA)?* Yes No I don't know ResumeResume Upload Drop files here or Select files Accepted file types: doc, docx, pdf, , Max. file size: 256 MB, Max. files: 2. Please upload a recent resume, for the most thorough assessment possible (optional) Your Family InformationDo you have a spouse (husband/wife) or common-law partner*?* Yes No *A common-law partner is your conjugal partner who is not legally married to you, but has been living with you for at least 12 consecutive months.Your Spouse / Common-Law PartnerHow old is your Spouse/Common-Law Partner?Under 1818192021222324252627282930313233343536373839404142434445464748495051525354555657585960 or olderWhat is his/her highest level of education completed?Less than secondary (high school)Secondary school (high school)1 year post-secondary2 years post-secondary3 years or more post-secondary2 Post secondary credentials, with one of more than three yearsMasters DegreePhD / Doctoral DegreeWhat is his/her English level?Select his/her English levelAdvanced / Fluent (CLB 9+)Upper Intermediate (CLB 8)Intermediate (CLB 7)Lower Intermediate (CLB 5-6)Elementary (CLB 4)None at all - Beginner (CLB 1-3)What is his/her French level?Select his/her French levelAdvanced / Fluent (CLB 9+)Upper Intermediate (CLB 8)Intermediate (CLB 7)Lower Intermediate (CLB 5-6)Elementary (CLB 4)None at all - Beginner (CLB 1-3)Has he/she worked outside of Canada within the past 10 years? Yes No How many years of full time work experience has he/she obtained outside Canada within the last 10 years?Select the amount of work experienceLess than 1 year1 years2 years3 years4 years5 years6 years or moreHas he/she worked INSIDE of Canada within the past 10 years? Yes No How many years of full time work experience has he/she obtained inside Canada within the last 10 years?Select the amount of work experienceLess than 1 year1 years2 years3 years4 years5 years6 years or moreProfession of your spouse/common-law partner Enter all professions from the past 10 yearsAdditional Comments on Your Spouse/Common-Law Partner Do you have any children under the age of 22?* Yes No How many children do you have under the age of 13?*Enter the number of childrenNone12345 or moreHow many children do you have aged 13 to 21?*Enter the number of childrenNone12345 or moreDo you or your Spouse/Common-Law Partner have any family members or relatives living in Canada?* Yes No RelationshipSelect his/her relation to you or your spouseSpouse or Common-Law PartnerMother or FatherGrandmother or GrandfatherSon or DaughterGrandson or GranddaughterSister or BrotherNiece or NephewAunt or UncleCousin (Child of Aunt/Uncle)Distant RelativeOther (please specify)Their Residency StatusSelect his/her residency statusCanadian CitizenPermanent ResidentWith Work PermitWith Study PermitWith Visitor PermitRefugee / Protected PersonOtherNot SureProvince of ResidenceSelect his/her province of residenceAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonLiving there sinceSelect how long he/she has been living in the provinceLess than 1 yearBetween 1 and 2 years2 years or moreAdd a second relative in Canada? Yes No RelationshipSelect his/her relation to you or your spouseSpouse or Common-Law PartnerMother or FatherGrandmother or GrandfatherSon or DaughterGrandson or GranddaughterSister or BrotherNiece or NephewAunt or UncleCousin (Child of Aunt/Uncle)Distant RelativeOther (please specify)Their Residency StatusSelect his/her residency statusCanadian CitizenPermanent ResidentWith Work PermitWith Study PermitWith Visitor PermitRefugee / Protected PersonOtherNot SureProvince of ResidenceSelect his/her province of residenceAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonLiving there sinceSelect how long he/she has been living in the provinceLess than 1 yearBetween 1 and 2 years2 years or moreAdd a third relative in Canada? Yes No RelationshipSelect his/her relation to you or your spouseSpouse or Common-Law PartnerMother or FatherGrandmother or GrandfatherSon or DaughterGrandson or GranddaughterSister or BrotherNiece or NephewAunt or UncleCousin (Child of Aunt/Uncle)Distant RelativeOther (please specify)Their Residency StatusSelect his/her residency statusCanadian CitizenPermanent ResidentWith Work PermitWith Study PermitWith Visitor PermitRefugee / Protected PersonOtherNot SureProvince of ResidenceSelect his/her province of residenceAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonLiving there sinceSelect how long he/she has been living in the provinceless than 1 yearBetween 1 and 2 years2 years or moreAdditional Comments on Your Family and Friends Application StatusHave you already submitted an Express Entry profile to the Government of Canada within the past 12 months?* Yes No Have you received an Invitation to Apply for permanent residence from the Government of Canada?* Yes No Available Funds for Immigration to CanadaAmount of Available Funds (in Canadian Dollars)*Enter your available fundsless than $10,000$10,000 to $20,000$20,000 to $30,000$30,000 to $40,000$40,000 to $50,000$50,000 to $100,000$100,000 to $200,000$200,000 to $500,000$500,000 or moredecline to answerIn order to demonstrate that you can support yourself and your family after arriving in Canada, a certain amount of available funds is required for most immigration programs. If you have more available funds you will have more options for Canadian immigration. Please enter the amount of money you (and your spouse) have access to for immigrating to Canada. When you apply, you may need to show that you have access to this money.Additional Information or QuestionsNameThis field is for validation purposes and should be left unchanged.
