Evaluation Relocation Assessment
Are you Currently Living in Canada?*
What type of permit do you have showing your status in Canada?*

* If study Permit was chosen please fill in additional information. 

What is the Name of your School. *
What is your Major/Area of Study?*
What is the total length of your program?*
How long have you been studying in Canada?*

* If you selected Post Grad please fill in the following:

What Date does your Current Permit Expire:*
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Do you Consent to your information Being shared with Potential Employers?*
Original Date of arrival to Canada? *
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General Information:

Name:*
Address:*
Phone:*
-
E-mail:*
Confrim E-mail:*
Date of Birth:*
 / 
 / 
Country Of Citizenship:*
Gender*
Marital Status:*
Do you Have Children?*
Are any of your dependants (spouse or children) in Canada?*
Dependent 1:
Is Dependant 1 in Canada?
Name 1:
Age 1:
Status 1:
Expiration 1:*
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Dependent 2:
Is dependant 2 in Canada?
Name 2:
Age 2:
Status 2:
Expiration 2:*
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 / 
Dependent 3:
Is Dependent 3 in Canada?
Name 3:
Status 3:
Age 3:
Expiration 3:*
Do you have an ongoing application for Permanent Residency in Canada?

* If Yes please answer the Following:

Program:
Province?
Status:
Submission Date:
 / 
 / 
Did an immigration lawyer/consultant assist you in this application?

Education:

Highest level of Completed Education:

Check yes in the next box if you meet the following Criteria:
- Your diploma was issued by the Government
- Your diploma has the seal or a written approval from the Ministry of Education ( or equivalent in your country)
- You possess a document from the Government that confirms your diploma is recognized

Was your Diploma issued or recognized by the Government?

Work Experience:

Employer 1 -----------------------------------------------------------------------------------------------------------------

From 1:*
 / 
 / 
To 1:*
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 / 
Title 1:*
Employer 1:*
Company 1:*
City 1:*
Country 1:*

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From 2:
 / 
 / 
To 2:
 / 
 / 
Employer 2:
Title 2:
Company 2:
City 2:
Country 2:

Employer 3 -----------------------------------------------------------------------------------------------------------------

From 3:
 / 
 / 
To 3:
 / 
 / 
Title 3:
Employer 3:
Company 3:
City 3:
Country 3:

Language Abilities: 

Basic: Only understand very basic sentences. Answers with a lot of hesitation, mus use body language and mother tongue to communicate
Moderate: Able to interact in a basic conversation and can interact on the phone in this language
High: Able to interact in most conversations and able to work in this language

Speaking French
French Listening:
Reading French:
Writing French:
Speaking English:
English Listening:
Reading English:
Writing English:
Have you ever taken any accredited English Language Testing System. (IELTS/ CELPIP) Either Academic or General From the Last 20 Months.*

*If Yes Please answer the following Questions: 

Answer from 1-10
 Please answer the score you received on your test!

Type of Exam:*
Score for LIstening:
Score for Speaking:
Score for Reading:
Score for Writing:
Date Taken:
Do you have relative(s) in Canada who is either a Permanent Resident or Citizen?*

*If you Chose Yes Please Answer the Following:

Relative 1:
Location/Province 1:
Relative 2:
Location/Province 2:
Relative 3:
Location/Province 3:
Word Verification: