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Eligibility Assessment Form for Immigration to Canada
Required fields are marked with an asterisk (
*
).
Personal Information
Title:
Please Select Title
Mr.
Ms.
Mrs.
*
Last Name:
*
Given Name(s):
*
Gender:
Please Select Gender
Male
Female
*
Citizenship:
*
Birthdate:
*
Email Address:
*
Phone Number:
*
Home Address:
*
Education
Educational Qualification:
Select Education
Ph.D.
Masters
Bachelors (2 separate degrees)
Bachelors (a single degree)
Associates Degree (USA)
College/Trade Diploma - 3 years
College/Trade Diploma - 2 years
College/Trade Diploma - 1 year
Higher National Diploma
High School Diploma
None of the above
*
Years of Further Studies after High School:
Years of Full-Time Study:
Work Experience / Business Experience
Profession/Nature of the Business:
Job Position:
Total number of years in the Profession/Business:
*For Business Applicants Only
If you are an owner of a business OR working in a managerial level in a business:
Total number of full time staff currently working directly under you:
If corporation, percentage of your share holding in the company:
Percentage of your spouse’s share holding in the company:
Estimated annual sales of the company or business in Canadian Dollars:
Estimated annual Net Income of the company or business in Canadian Dollars:
Your personal total (without your spouse) net worth in Canadian Dollars:
Net worth means everything you own, such as properties, business, cash in the bank, stock and shares etc.
Language Proficiency
Proficiency in English
Speaking:
Please Select
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
*
IELTS Test Score:
Please Select
Have not taken this test
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
*
Writing:
Please Select
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
*
Reading:
Please Select
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
*
Listening:
Please Select
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
*
Proficiency in French
Speaking:
Please Select
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
TEF Test Score:
Please Select
Have not taken this test
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
Writing:
Please Select
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
Reading:
Please Select
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
Listening:
Please Select
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
Spouse Details (If Married)
Last Name:
First Name:
Birthdate Spouse:
Educational Qualification:
Select Education
Ph.D.
Masters
Bachelors (2 separate degrees)
Bachelors (a single degree)
Associates Degree (USA)
College/Trade Diploma - 3 years
College/Trade Diploma - 2 years
College/Trade Diploma - 1 year
Higher National Diploma
High School Diploma
None of the above
Years of Full-Time Study:
Profession:
Years of Professional Practice:
Proficiency in English
English:
Please Select
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
Writing:
Please Select
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
Reading:
Please Select
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
Listening:
Please Select
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
Proficiency in French
French:
Please Select
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
Writing:
Please Select
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
Reading:
Please Select
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
Listening:
Please Select
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
Dependants
Dependent children
under the age of 19
Name of Dependants
Age
Son or Daughter
1
Select
Son
Daughter
2
Select
Son
Daughter
3
Select
Son
Daughter
4
Select
Son
Daughter
Do you or your spouse have any blood relatives in Canada?
Please Select Relatives
No Relatives in Canada
My Parent(s)
My Grandparent(s)
My Sister or Brother
My Aunt or Uncle
My Niece or Nephew
My Daughter or Son
My Spouse or Common-Law Partner
A Parent of my Spouse or Common-Law Partner
A Grandparent of my Spouse or Common-Law Partner
A Sister or Brother of my Spouse or Common-Law Partner
An Aunt or Uncle of my Spouse or Common-Law Partner
A Niece or Nephew of my Spouse or Common-Law Partner
A Daughter or Son of my Spouse or Common-Law Partner
*
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