Phone: 416-651-8889

Immigration Services

Canadian Experience Class Assessment Form

Name:

Email address:

Phone number:

City/ Country residing now:

Your citizenship – nationality :

Marital status:

Children # and ages:

How did you hear of us?

Highest Canadian Education completed and the school:

Highest number of years completed in Canadian education:

Highest Canadian Education Date of Completion:

Your earned Canadian Degree:

Graduation date:

Do you have a Post Grad Work (PGWP) permit now:

When was your PGWP issued?

For how many years?

When does it expire:

Your job titles for past 3 years / How long worked at each position in years:

Did you get a T4 from employer?

Did you file your taxes, and have your Notice of Assessments?

Job offer from Canadian Employer:

Have a LMIA?

English (or French) Language test completed, name – type of test taken:

Scores: Reading:

Writing

Speaking

Listening Comprehension:

Date of Language Test results report:

Are you still in Canada?

If not, when did you leave?

What was the last date worked in Canada?

Do you or any family member have any medical condition:

Do you or your family have any police record:

Special circumstances you want us to know about:

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