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ASSESSMENT FORM

ASSESSMENT FORM

Principal Applicant Name *

First

Last

Age *

Email *

Phone Numbers *

Education (Name of the Institution - Year of graduation) *

Work Experience ( Job title, How Long) *

English Level *

IELTS Score Reading

IELTS Score Writing

IELTS Score Listening

IELTS Score Speaking

French Level *

TEF Score Reading

TEF Score Writing

TEF Score Listening

TEF Score Speaking

Marital Status *

Number of Dependents

Describe Dependent Relation and Age

Employment Insurance

Yes
No

If Yes, How long?

Years

Medical Condition

Yes
No

If Yes, Explain:

Do you have any close relative in Canada

Yes
No

If Yes, Explain:

Have you ever committed, been arrested for, or been charged with or convicted of any criminal offence in any country or territory?

Yes
No

If Yes, Explain:

Have you ever been refused entry to Canada?

Yes
No

If Yes, provide the date and type of application:

Schengen Visa

Yes
No

If Yes, Indicate where and when

Please list all previous countries of residence in the last five years if any

Financial Statement of available fund in Canadian Dollars

Total net worth

Hard assets such as House

Car

Cash in bank

Investment

Savings

Business

Other

Information of Spouse *

First

Last

Spouse Age

Spouse Education (Name of the Institution - Year of graduation) *

Spouse Work Experience ( Job title, How Long) *

Spouse English Level *

Spouse IELTS Score Reading

Spouse IELTS Score Writing

Spouse IELTS Score Listening

Spouse IELTS Score Speaking

Spouse French Level *

Spouse TEF Score Reading

Spouse TEF Score Writing

Spouse TEF Score Listening

Spouse TEF Score Speaking

Spouse Employment Insurance

Yes
No

If Yes, How long?

Years

Spouse Medical Condition

Yes
No

If Yes, Explain:

Have your spouse ever been refused entry to Canada?

Yes
No

If Yes, provide the date and type of application:

Spouse Schengen Visa

Yes
No

If Yes, Indicate where and when

Please list all previous countries of residence in the last five years if any

Phone

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(416) 562 9090

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ASSESSMENT FORM

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About this Program