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Free Express Entry Evaluation Form/Free

Express Entry is a simplified, fast and efficient immigration selection system offering permanent residence in 6-months to qualified skilled workers.

Complete the following questionnaire and receive in 1-2 days a free assessment of your qualifications for Canadian permanent residence under the Express Entry System.

Personal Information

Name:*

Email:*

Nationality:*

Current Place of Residence: (City,Country):*

Contact Number:*

Date of Birth:*

Sex:*

Male Female Other

Marital Status:*

Single Married Divorced/Separated
If Married, please provide Spouse's Characteristics in the fields below

Spouse's Date of Birth:

Spouse's Level of Education and duration:

Spouse's total years of education:

Spouse's field of study:

Spouse's Number of Years and Months of Working Experience:

Language Ability in French:

Number of Dependant Children:

Ability in English and French
English

Read

Write

Speak

Listen

French

Read

Write

Speak

Listen

Educational Profile

Total Years of education:

1. Certificate:

Field of Study:

Date Started:

Date of Graduation:

Name of Institution:

City:

Country:

2. Certificate:

Field of Study:

Date Started:

Date of Graduation:

Name of Institution:

City:

Country:

3. Certificate:

Field of Study:

Date Started:

Date of Graduation:

Name of Institution:

City:

Country:

Employment History/Expériences professionnelles

1. Name of Company or Organization/Nom de l'Employeur:

Job Title:

From date

To date

Employment Status:

Part Time Full Time

Number of Hours Worked per Week:

Do You Presently Still Work at this Company? (Yes/No):

City:

Country:

Employment Duties: (please provide details)

2. Name of Company or Organization/Nom de l'Employeur:

Job Title:

From date

To date

Employment Status:

Part Time Full Time

Number of Hours Worked per Week:

Do You Presently Still Work at this Company? (Yes/No):

City:

Country:

Employment Duties: (please provide details)

3. Name of Company or Organization/Nom de l'Employeur:

Job Title:

From date

To date

Employment Status:

Part Time Full Time

Number of Hours Worked per Week:

Do You Presently Still Work at this Company? (Yes/No):

City:

Country:

Employment Duties: (please provide details)

If you have additional experience, please include in the Additional Comments below.

Other

• Relationship to Closest Blood Relative in Canada (Canadian Citizen or Landed Immigrant):

Blood Parent Blood Aunt/Uncle Blood Brother or Sister Blood Son/Daughter
Blood Niece/Nephew (22 years or older) Blood Grand Parent Blood Cousin
Relative Province of Residence :

• Personal Net worth (CAD$):

• Do you currently have an offer of employment from a Canadian employer?

Yes No

If your answer to the above question is "Yes" provide details here:

Have you or spouse/common law partner or dependent children ever:

• Had any serious disease

Yes No

• Been convicted of or currently charged with any crime or offence in any country

Yes No

• Applied previously for an immigrant visa to Canada

Yes No

• Visited Canada (visit,study,work)

Yes No

Are you able to obtain a visitors visa to Canada

Yes No

If answer to any of above is "Yes" provide details here:

Additional Information :

Information