Personal Details
Please provide us with your name and address information. |
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Salutation |
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First Name |
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| Middle Name |
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Last Name |
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| Gender |
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Date of Birth |
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| *Marital Status |
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| *Country of Citizenship |
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| Correspondence Details |
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Mailing Address |
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| City |
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| State/Province |
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| Country |
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| Postal Code |
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Residential Address
Leave blank if same as above. |
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| City |
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| State/Province |
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| Country |
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| Postal Code |
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*Legal Status
in country of residence |
e.g., Citizen, On Student Visa, On Work Permit etc. |
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Home Phone
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Ctry Cd. - Area Cd.- Phone No.
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| Other Phone |
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| Cell Phone |
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| Fax |
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| * Email |
Please ensure this email is active and valid as your assessment result will be sent on this address.
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Other Immigration Specific Information
Your assessment is based on your education and work details as well. |
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Years of Formal Education
From Primary Education |
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* Highest Level of Completed
Education |
Master's or Ph.D.
2 or more Bachelor's degrees
Bachelor's - 4 Years
Bachelor's - 3 Years
Bachelor's - 2 Years
Bachelor's - 1 Year
Diploma/Trade Cert./Apprenticeship - 3 Yr
Diploma/Trade Cert./Apprenticeship - 2 Yr
Diploma/Trade Cert./Apprenticeship - 1 Yr
Completed secondary school (high school)
Did not complete secondary school (high school)
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When was the highest education completed |
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Stream (Arts, Commerce, Medical, Non-Medical etc.) |
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Proficiency in English |
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Proficiency in French |
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Are you willing to undergo language training/testing in English or French? |
Yes
No
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| Do you have an HRDC confirmed job offer from a Canadian employer? |
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| Have you worked in Canada for at least 1 year on a work permit? |
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| Did you attend post secondary studies in Canada for more than 2 years? |
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| Do you have a blood relative in Canada? |
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Spouse/Common-law-partner's Details
(If Applicable)
In some cases it may be possible that you may not qualify whereas your
spouse/common-law-partner will. So provide us with your spouse/common-law-partner's
information as well. If this is not applicable to you simply click Next
to skip the information. |
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Salutation |
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First Name |
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| Middle Name |
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Last Name |
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| Gender |
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Date of Birth |
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Years of Formal Education
From Primary Education |
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* Highest Level of Completed
Education |
Master's or Ph.D.
2 or more Bachelor's degrees
Bachelor's - 4 Years
Bachelor's - 3 Years
Bachelor's - 2 Years
Bachelor's - 1 Year
Diploma/Trade Cert./Apprenticeship - 3 Yr
Diploma/Trade Cert./Apprenticeship - 2 Yr
Diploma/Trade Cert./Apprenticeship - 1 Yr
Completed secondary school (high school)
Did not complete secondary school (high school)
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Stream (Arts, Commerce, Medical, Non-Medical etc.) |
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Years of Full Time Work Exp. |
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Current Occupation |
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For a more accurate assessment please provide details of your spouse/common-law-partner's last 3 jobs starting with the latest
Leave To date blank for 'till date'
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* Proficiency in English |
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Proficiency in French |
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| Do you have an HRDC confirmed job offer from a Canadian employer? |
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| Have you worked in Canada for at least 1 year on a work permit? |
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| Did you attend post secondary studies in Canada for more than 2 years? |
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| Do you have a blood relative in Canada? |
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| Financial Information (in Canadian Dollars) |
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* Total Monthly Income of you and your spouse (if applicable)
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Your Total Net Worth
(This must be your own and not jointly owned by spouse)
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* Total Savings (in Banks and Other Investments)
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Brief description of financial resources to cover immigration costs
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| Business Experience (Past 5 years) |
| Most recent/current business details: |
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* Name of business
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Your Profile
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* Details of Business including nature of business, type of business i.e.,
proprietorship, partnership or corporation, annual sales, income and assets in Canadian
dollars.
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* Total Years in this business and/or management position.
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| Previous business details: |
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Provide details of your previous businesses including your profile, nature of business, type of business i.e.,
proprietorship, partnership or corporation, annual sales, income and assets in Canadian
dollars, total years in business and/or management position.
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Total Years in previous businesses and/or management position.
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| Final Information |
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* How did you come to know about us?
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Paste your text resume here:
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I hereby declare that the information given in this assessment form is true to the best of my knowledge and belief. I understand that Green and Spiegel can use this information to contact me via all modes of communication and send information as required.
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| Security code: |
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