Canadian Immigration Assessments

1. Number of years completed at the elementary level:
2. Number of years completed at the High School level:
3. Number of years completed at the post secondary level:
4. Highest level of education completed:
5. Name of the educational establishment:
6. Duration of the program (in years):
7. Title of the diploma obtained:

FULL TIME WORK EXPERIENCE (within the past 10 years)

1. Title of employment position:
2. Employment period: (mm/yyyy) to (mm/yyyy)
3. Title of employment position:
4. Employment period: (mm/yyyy) to (mm/yyyy)
5. Title of employment position:
6. Employment period : (mm/yyyy) to (mm/yyyy)

1. On a scale of zero to 10 (10 being the highest), what is your level of English? 0 1 2 3 4 5 6 7 8 9 10
2. On a scale of zero to 10 (10 being the highest), what is your level of French? 0 1 2 3 4 5 6 7 8 9 10

1. Age:
2. Highest level of education achieved:
3. Name of the educational establishment:
4. Duration of the program (in years):
5. Title of the diploma obtained:
6. On a scale of zero to 10 (10 being the highest), what is your spouse’s level of French? 0 1 2 3 4 5 6 7 8 9 10

1. Do you have any family members in Canada? Yes No
2. Relationship to you:
3. Province of residence of the family member:

1. Were you in Canada within the past 10 years? Yes No
   Dates of the stay in Canada: (from to )
   Purpose of the stay (work, business, study, tourism):
   Province of the stay in Canada: