To obtain a free assessment of your eligibility please ...



Free PNP Skilled Assessment for Canadian Immigration

Please mention [Yes] where ever applicable in the brackets [ ] provided

|CLIENT ASSESSMENT FORM |

|Principal Applicant |

|Last Name: |First Name: |Middle Name: |

| |House No: |Street: |City: |

|Mailing Address | | | |

| | | | |

| |State: |Country: |Postal Code: |

| | | | |

|Telephone |Home: |Business: |

| |Fax: |Mobile: |

| |Email: | |

|Date of Birth |Day: |Month: |Year: |Sex: |

|Place of Birth |City: |State: |Country: |

|Citizenship: | |

|Passport |Passport Number: |Passport Issued on: |Passport Expires on: |

| | | | |

|Marital Status: |Never Married [ ] |Engaged [ ] |Married [ ] |

| |Widowed [ ] |Separated [ ] |Divorced [ ] |

| |Spouse Information |

|Spouse Info: |If you are married or engaged please provide details of spouse |

|Full Name: | |

|Date of Birth |Day: |Month: |Year: |Sex: |

|Place of Birth |City: |State: |Country: |

|Citizenship: | |

|Passport |Passport Number: |Passport Issued on: |Passport Expires on: |

| | | | |

|Occupation: | |

|Experience: | |

|Marriage Date |Day: |Month: |Year: |Place: |

| | |

|Education - Spouse - Mention [Yes] where applicable |

|Highest Completed |University Degree |Non University Diploma |

|Primary School |1 year University credential [ ] |One year [ ] |

|High School |2 year University credential [ ] |Two year [ ] |

| |3 year University credential [ ] |Three year [ ] |

| |Bachelor’s degrees [ ] | |

| |Masters & PhD [ ] | |

|Years of Education |How many years of Education has spouse completed: | [ ___ Years] |

| |Family Information |

|Children |Full Name: |Date of Birth: |Son: |Daughter: |

| | | |[ ] |[ ] |

| | | |[ ] |[ ] |

| | | |[ ] |[ ] |

| |Total number of Children below 22 years of Age [ ___ years] |

| |Total number of Children above 22 years of Age [ ___ years] |

| |Relatives In Canada |

|Do you/your spouse have relatives living in Canada?:Mention Yes/No: | [ ] |

|Name: |Relationship: |Status in Canada: |

| | | |

| | | |

| |Principal Applicant Education |

|Academic Info | |

|Period |Name & Address of Institutions:|Courses |% |Degree / Diploma / Certificate |

| | | | |Issued: |

|From: |To: | | | | |

| | | | | | |

| | | | | | |

| | | | | | |

| | | | | | |

|Total Years of Education successfully completed | [ ___Years] |

| | |

| |Principal Applicant Employment |

|Work History | |

|Date |Name & Address of Employer: |City & Country: |Job Designation: |

|From: |To: | | | |

| | | | | |

| | | | | |

| | | | | |

| | | | | |

| | | | | |

| | | | | |

|Detailed Responsibilities & |List duties & responsibilities of each position at previous employment since last 10 years: |

|Duties | |

| | |

|Trade or Profession: |Current Occupation |NOC Number: |

| | | |

|Job Description: |Please attach a separate sheet giving a detailed description of the job responsibilities performed |

| |by you on a day to day basis: |

|Total Work Experience: |How many years of work experience do you have in the last 10 years? |

| |1 [ ] |

| |2 [ ] |

| |3 [ ] |

| |4 [ ] |

| |More [ ] |

| | |

| | |

|Intended Job In Canada: | |

|Preparation for PNP program |

|In Which Province are you interested in settling down? Mention |Prince Edward [ ] |Ontario [ ] |

|[Yes] where applicable | | |

|Alberta [ ] |Saskatchewan [ ] |Newfoundland [ ] |Quebec [ ] |

|Nova Scotia [ ] |New Brunswick [ ] |Yukon [ ] |Nunavut [ ] |

|British Columbia |Manitoba [ ] |Northwest Territories [ ] |Not Sure [ ] |

|[ ] | | | |

| | |

|Do you have the ability to become economically established in a particular province? Mention Yes/No : | [ ] |

|Do you have the right Occupational skills that would fill critical labor shortages in a Particular province?| [ ] |

|Mention Yes/No : | |

|Do you have the training, work experience and language ability to be employed in a Particular province? | [ ] |

|Mention Yes/No : | |

|Have you initiated contact with an employer in search of a job in a particular province, as negotiating an | [ ] |

|“Offer of Employment” is an applicant’s responsibility? Mention Yes/No : | |

|Do you want us to obtain “ Letter of Employment” based on your occupation if it meets labor shortages in any| [ ] |

|of the provinces? Mention Yes/No : | |

|Do you have a guaranteed permanent job offer from an employer in any of the provinces? Mention Yes/No : | [ ] |

|If yes which province? Mention [Yes] where applicable: |

|Alberta [ ] |

|Saskatchewan [ ] |

|Newfoundland [ ] |

|Quebec [ ] |

| |

|Nova Scotia [ ] |

|New Brunswick [ ] |

|Yukon [ ] |

|Nunavut [ ] |

| |

|British Columbia [ ] |

|Manitoba [ ] |

|Ontario [ ] |

|Northwest Territories [ ] |

| |

|Prince Edward Isl |

|Not Sure [ ] |

| |

| |

| |

| |

| |If yes give Employer’s details: |

|Employer Name | |

|Address |Street: |City: |Province: |

| |Phone: |Fax: |Email: |

| | |

|Position Details |Job title: |

|Position Description: Attach description & required qualifications |

| |

|Annual Salary |$ |

|Education Requirements |Technical training |College |University |

| | |

|Do you have the Occupational skills that falls into the National Occupational Classification Matrix | [ ] |

|(www23.hrdc-drhc.gc.ca) level “O”, “A” or “B” or an equivalent apprenticeship –able trade? | |

|Do you have the appropriate Licensing or Accreditation needed to work in your occupation of any province | [ ] |

|in Canada? | |

|As an applicant to this program, will you make a commitment and sign a Declaration stating your intention| [ ] |

|to live, work and settle permanently in any particular province? | |

| | |

| |LANGUAGES |

|Language Ability |Please indicate your ability to communicate in English and French by checking the appropriate column|

| |Mention [Yes] where applicable |

|English |Speak |Read |Write |Understand |

| |[ ] |[ ] |[ ] |[ ] |

| | |

|French |Speak |Read |Write |Understand |

| |[ ] |[ ] |[ ] |[ ] |

| | |

|Language Test |Have you or could you pass a formal English/French Language Test? Mention Yes / No: |

| |English : [ ] |French : [ ] |

| | |

| |Language Test Results |

|English |IELTS | | | |

|Overall Score |Listening |Reading |Writing |Speaking |

| | | | | |

|French | | | | |

|Overall Score |Listening |Reading |Writing |Speaking |

| | | | | |

| |ADDITIONAL INFORMATION |

|Do you hold a Work permit for Canada? Mention Yes / No: | [ ] |

|Do you have a Job offer or potential job offer from a Canadian employer? Mention Yes / No: | [ ] |

|Have you or your spouse, common law partner or same sex partner ever worked in Canada for one full year? | [ ] |

|Mention Yes / No: | |

|Have you or your spouse, common law partner or same sex partner ever studied in Canada for more than two | [ ] |

|years? Mention Yes / No: | |

|Do you or your spouse, common law partner or same sex partner have a valid offer of Employment in Canada | [ ] |

|upon your arrival? Mention Yes / No: | |

|Do you have a spouse, common law partner or same sex partner who is a Canadian Citizen or Permanent | [ ] |

|Resident? Mention Yes/ No: | |

|Do you or your spouse, common law partner or same sex partner have any close family relationships in | [ ] |

|Canada? Mention Yes / No: | |

|If you have answered 'Yes' to any of the above questions, please provide details below: |

| |BUSINESS INFORMATION |

|Have you ever owned and operated your own business? Mention Yes / No: | [ ] |

| |If yes, email a complete business profile of your company to info@ |

|Company Profile |Details of business activities should include: Type of Business, your role, duties and |

| |responsibilities within the business. |

| |FINANCIAL INFORMATION |

|Do you have the Financial resources to adequately settle yourself in a Particular province? Mention Yes /| [ ] |

|No: | |

|Net Worth |Bank: |

| |Property: |

| |Assets: |

| |Other: |

| |Total: |

| | |

| | |

| | |

| | |

| | |

| | |

| | |

| |If others give details here: |

|Transferable Funds / Assets: |Cash (in Cdn$): |Property (in Cdn$): |

| | |

| |PRIOR APPLICATION TO CANADA |

|Have you ever visited Canada? Mention Yes / No: | [ ] |

|Who did you visit |Where: |When: |Purpose: |

| | | | |

|Have you ever studied in Canada? Mention Yes / No: | [ ] |

|If yes, give details |Name of Institution: |Course of study: |Date: |

| | | | |

|Have you ever worked in Canada? Mention Yes / No: | [ ] |

|If yes, give details |Name of Employer: |Occupation: |Date: |

| | |

|Have you ever been refused a visa? If yes, provide details below: Mention Yes / No: | [ ] |

|If yes, provide details below: |

|Why Canada? |Briefly explain your interest in immigrating to Canada?: |

| | |

|Other Notes: |Any other information you believe that is relevant to this assessment?: |

|Why Us? | |

|How did you come to know about our Immigration Consultancy firm? Mention [Yes] where applicable: |

|Referral [ ] |Friend [ ] |Seminar [ ] |

|Newspaper [ ] |Internet [ ] |Other [ ] _________ |

| | |

| |PASTE RESUME HERE (Optional) |

| |

| |

|In addition to the Assessment form you may send an updated Resume or Curriculum vitae, if available, as an attachment to our email |

|info@ |

|DECLARATION | |

|I agree that the information furnished by me in the above form is true and correct, to the best of my knowledge, and given for the |

|sole purpose of my FREE assessment regarding Immigration to Canada under any of the PNP Programs offered by various provinces.. |

|(YES/NO) |

| |

|Date: |

|Place: |

| |

| |

|All information provided in this form will remain strictly confidential and secure. It will not be shared with any external |

|sources. This information is used for the sole purpose of preliminary assessment of your chances to successfully immigrate to |

|Canada. Please see our Privacy Policy. |

| |

|Thank You! |Information provided to our firm is strictly Private & Confidential. |

| |

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