Skilled Worker Free Assessment Form

A. Personal Details

• Family Name *

• Given Name

• Gender
• Male Female

• Address

• Home Phone Number (ex. 416-123-4567)

• Business Phone Number (ex. 416-123-4567)

• Mobile Phone Number* (ex. 416-123-4567)

• Fax Number

• E-mail Address *

• Confirm E-mail address *

• Alternate E-mail address

• Date of Birth

• Place of birth

• Citizenship

• Country of Residence

• Marital Status

• Number of Children

• Age of Children

B. Spouse’s (husband, wife, or common-law partner) personal details (if applicable)

• Family Name

• Given Name

• Gender
• Male Female

• Date of Birth

• Place of Birth

• Citizenship

• Country of Residence

C. Education

• Your total number of years of full-time education

• Highest level of education achieved
• Select Secondary school 1-year post-secondary credential 2-year post-secondary credential 3 or more year post-secondary credential Two or more post-secondary credentials, one of which was at least 3 years in duration University credential at the master’s or professional level University credential at the doctoral level

• Details of education: (provide type of degrees/diplomas, where obtained, full or part-time, area of study, and whether program was completed)

Spouse’s Education (if applicable)

• Your spouse’s total years of education
• Select Secondary school 1-year post-secondary credential 2-year post-secondary credential 3 or more year post-secondary credential Two or more post-secondary credentials, one of which was at least 3 years in duration University credential at the master’s or professional level University credential at the doctoral level

• Details of education: (provide type of degrees/diplomas, where obtained, full or part-time, area of study, and whether program was completed)

D. Language Skills

• English

  • Speak
  • none basic well fluently
  • Listen (oral comprehension)
  • none basic well fluently
  • Read
  • none basic well fluently
  • Write
  • none basic well fluently

• French

  • Speak
  • none basic well fluently
  • Listen (oral comprehension)
  • none basic well fluently
  • Read
  • none basic well fluently
  • Write
  • none basic well fluently

• If you have ever been tested for language ability under the IELTS, CELPIC or the TEF test, please record your scores here

Spouse’s Language Skills (if applicable)

• English

  • Speak
  • none basic well fluently
  • Listen (oral comprehension)
  • none basic well fluently
  • Read
  • none basic well fluently
  • Write
  • none basic well fluently

• French

  • Speak
  • none basic well fluently
  • Listen (oral comprehension)
  • none basic well fluently
  • Read
  • none basic well fluently
  • Write
  • none basic well fluently

• If your spouse has ever been tested for language ability under the IELTS, CELPIP or the TEF test, please record their scores here

E. Age

• Date of birth Spouse or partner’s date of birth (if applicable)

F. Work Experience

• Total number of years of full-time skilled work experience in the past 10 years

• Present job

• Previous job 1

• Previous job 2

• Previous job 3

• Previous job 4

• Are there any details you wish to add about your work experience?

• If you wish to attach your resume please paste it here.

G. Spouse’s Work Experience (if applicable)

• Total number of years of full-time skilled work experience in the past 10 years

• Present job

• Previous job 1

• Previous job 2

• Previous job 3

• Previous job 4

• Are there any details you wish to add about your work experience?

H. Arranged Employment

• Are you currently working in Canada with a work permit for which a Labour Market Opinion has been obtained, and is your employer willing to offer you a permanent position?
• Yes No

• Do you have a job offer from a Canadian company that is willing to employ you permanently once you obtain permanent residence?
• Yes No

• Is your spouse or partner (if applicable) currently working in Canada with a work permit for which a Labour Market Opinion has been obtained, and is their employer willing to offer them a permanent position?
• Yes No

• Does your spouse or partner have a job offer from a Canadian company that is willing to employ them permanently once they obtain permanent residence?
• Yes No

I. Adaptability

• Have you or your spouse or common-law partner studied full-time in Canada for at least a two-year period?
• Yes No

• Have you worked full-time in Canada in a skilled occupation for at least a one-year period?
• Yes No

• Has your spouse or common-law partner worked full-time in Canada for at least a one-year period?
• Yes No

• Do you or your spouse have any family members in Canada who are citizens or permanent resident?
• Yes No
  spouse child father mother brother sister grandfather grandmother uncle aunt nephew niece other (explain relationship)

J. Net Worth

• What is your monetary net worth, including your assets and the assets of your spouse, in Canadian dollars?

K. Admissibility

• Have you, your spouse, or any of your children

• Had any serious disease or physical or psychological disorder?
• Yes No

• Been convicted of or are currently charged with a criminal offence in any country?
• Yes No

• Applied previously for a temporary visa to Canada?
• Yes No

• Applied previously for permanent residence in Canada?
• Yes No

• Been refused a visa to Canada or any other country?
• Yes No

• Been refused admission to or order removed from Canada or any other country?
• Yes No

• Been involved in the commission of human rights violations, acts of subversion, espionage, terrorism, or organized criminality?
• Yes No

• If you have replied “yes” to any of the above questions, please provide details

L. Final Details

• If there is anything else that you believe is important in relation to your qualifications please note it here. For example, if you have a resume you can paste it here.

Declaration

• I () certify that the above information provided by me in the Free Assessment is true. *

• Furthermore, I consent to the law office of Matthew Jeffery, Barrister & Solicitor, contacting me in relation to the above Free Assessment. *

• Please select the Circle and click the Submit button.

  

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