Assessment Form
Immigration Matters

Download PDF or fill the following form:

A. MAIN APPLICANT

Personal Information
Name*
Email*
Phone*
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Date of Birth*
Date Format: MM slash DD slash YYYY
Sex
- Male
- Female
- Prefer Not to Answer
Country of Citizenship*
Marital Status*
- Single
- Married
- Divorced
- Widowed
Dependent Children*
Educational Profile
Have you received any post-secondary education or training in Canada?*
- Yes
- No
Have you received any post-secondary education or training in any other countries?*
- Yes
- No
Name the highest level of your education*
Name the institution*
Place (city, country)*
Timeline (from – to)*
Employment History
Have had paid work experience in the past 10 years in Canada?*
- Yes
- No
Have had paid work experience in the past 10 years in any other countries?*
- Yes
- No
Name of Company or Organization*
Place (city, country)*
Job Title*
Timeline (from – to)*
Employment Status*
Canadian Job Offer
Do you have a written job offer from a Canadian employer?*
- Yes
- No
Occupation*
Province*
What is the contract duration?*
Is this job offer supported by a Labour Market Impact Assessment (LMIA)?*
Ability in English and French
Language*
- IELTS
- CELPIP
IELTS*
Speaking Listening Reading Writing
CELPIP*
Speaking Listening Reading Writing
Travel History
List all the countries you have visited in the past 10 years:*
Country Timeline
Your Personal Net Worth

Insert the value of the following assets currently in your possession (if applicable)
Bank account
All assets (stocks, properties, cash, etc)
Do you have experience managing a business?*
- Yes
- No
Have you ever owned and operated your own business?*
- Yes
- No
Family or Friends in Canada
Do you have a close friend living in the province of Manitoba who is 18 years or older? (if yes, what is their status)*
Do you have any family members or relatives living in Canada and who are 18 years or older? (if yes, what is their status)*
Does your family member who resides in Canada owns a business in Canada? (if applicable)
Application History
Have you ever applied to come to Canada? (if yes, when and what type of application)*
Have you ever been rejected admission to Canada, or any other countries?*
Have you ever claimed refugee in any countries?*
Admissibility
Have you ever been convicted of a criminal offence?*
Do you or your immediate family members have a medical condition?*
B. SPOUSE/COMMON LAW PARTNER (IF APPLICABLE)

Educational Profile
Have you received any post-secondary education or training in Canada?
- Yes
- No
Have you received any post-secondary education or training in any other countries?
- Yes
- No
Name the highest level of your education
Name the institution
Place (city, country)
Timeline (from – to)
Employment History
Have had paid work experience in the past 10 years in Canada?
- Yes
- No
Have had paid work experience in the past 10 years in any other countries?
- Yes
- No
Name of Company or Organization
Place (city, country)
Job Title
Timeline (from – to)
Employment Status
Ability in English and French
Language
- IELTS
- CELPIP
IELTS
Speaking Listening Reading Writing
CELPIP
Speaking Listening Reading Writing
Phone
This field is for validation purposes and should be left unchanged.