General Immigration

First Name*

Last Name*

Email Address*

Country of citizenship*

What is your Country of Residence?*

Age*

Marital Status*

Do you have any Dependent Children?

Yes
No

Telephone

Dependent Children:

Your dependent children include all children that are not married and financially dependent on you who are less than 22 years old.
Please indicate how many children you have using the following drop down menus.

12 years and younger

13 to 21 years

22 years and older

Your education and training

Have you received any post-secondary education or training?*

Yes
No

Current (or most recent) Program of Study

Location

Field of study*

Did you complete this program?

Yes
No

Work Experience

Have you had paid work experience in the last 10 years?

Yes
No

Current (or most recent) Job:

Employment type

Job Start Date

Job End Date

Location

Canadian Language Proficiency

First official language

Proficiency

Second official language

Proficiency

Other

Please select all statements that apply to you or any of your accompanying family members:

Do you have a written job offer from a Canadian employer?*

Yes
No

Do you, or your Spouse/Common-Law Partner, have any family members and or extended relatives living in Canada?

Yes
No

This Person is your:

Residency Status

I have a criminal record

Yes
No

I have a serious medical condition

Yes
No

Questions and comments

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Comments

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Online Canadian Immigration Assessment.