Initial Assessment Form
Initial Assessment Form for Permanent Residence, Work Permit, Study Permit
First Name (as it appears on your passport)
Your answer
Middle Name (as it appears on your passport)
Your answer
Last Name (as it appears on your passport)
Your answer
Are you inside or outside Canada?
What type of service are looking for?
Gender
Complete Residential Address (at present)
Your answer
Contact Number
Your answer
Email Address
Your answer
Birthday
MM
/
DD
/
YYYY
Marital Status
City and Country of Birth
Your answer
Current Country of Residence
Your answer
If different from your country of birth, please indicate below (Country, Status, From and to) *
Your answer
Current Immigration Status in the Country of Residence
Number of Children
Your answer
Level of Education obtain inside Canada
Level of Education obtain outside Canada
Work Experience- what is your present job title?
Your answer
How many years have you been working under that job title?
Your answer
What was your previous job title prior to your present job?
Your answer
How many years have you been working under that job title?
Your answer
Do you have IELTS?
If you have IELTS, what type of exam did you take?
Please write your scores per category below for Listening, Reading, Writing and Speaking. Write Not Applicable if you do not have IELTS.
Your answer
Date of IELTS Exam
MM
/
DD
/
YYYY
Do you have a brother or sister in Canada who is a permanent resident or Canadian citizen?
Do you have a job offer from an employer?
Do you have a provincial nomination?
Do you have a provincial nomination?
Did you study in Canada?
How many years did you study in Canada?
Who is your main contact person in Canada Visa Express?
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