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Independent Skilled Worker

Age<br /> Education<br/>English<br/>French<br/>Work Exp<br/>Arr Empl<br/>Adaptability<br/>Partner Ed<br/>Cdn Emp<br/>Cdn Ed<br/>Arr Empl<br/>Cdn Family<br/>Total<br/>Conditional on:<br/> ——————————————————–<br/>

Please complete this brief confidential form in full in English or French. Only fully completed forms will be reviewed, assessed, and replied to.

Contact Information

Given name(s)
Surname (Family name(s))
Date of birth (day/month/year)

Telephone Number
Fax Number
E-mail address

Country currently residing in
How did you hear of us?

Education

In this section, please list only completed full-time studies at accredited institutions, where the program completed was at least one academic year in length, where you graduated from the program with a diploma, certificate or degree. Full time studies is defined as a weekly total of 15 hours of classroom and studies per week. Please do not list incomplete, part-time or short courses of less than one academic year.

Did you graduate from High School?
Total number of years in primary and high school

Please list all full time Diplomas, Certificates, or Degrees, and # of years to complete each program. Give the specific name of your degree or diploma: i.e. Bachelor’s or Master’s Degree in Engineering, Certificate in IT, etc.

Total number of years full time post-secondary study
Total number of years of full time study

Financial Details

Total net worth (patrimonio) in Canadian Dollars (savings + properties + investments + assets)
Settlement funds: Money you have available to bring to Canada.

Employment History

Please specify for each job you have had in the last 10 years. In the Main Duties section, please add one full sentence with complete details of your job duties.
Job Title
Length of Employment	years	months
Main duties

Job Title
Length of Employment	years	months
Main duties

Job Title
Length of Employment	years	months
Main duties

Job Title
Length of Employment	years	months
Main duties

Job Title
Length of Employment	years	months
Main duties

Marital Status

Current Marital Status
My spouse or common-law partner or conjugal partner is a Canadian citizen or a Canadian Permanent Resident (landed immigrant)

	Common-law Definition: have a partner of either sex who you are living with and have lived with for at least one year in an physically intimate relationship. * Conjugal Partner Definition: in a conjugal relationship of at least a year with a Canadian or Canadian Permanent Resident partner of either sex, but have not lived together for a total of twelve months.

Do you have a job offer from a Canadian employer who will definitely hire you when your permanent resident application is successful?
Do you have a job offer from a Canadian employer that has been approved by Human Resources Development Canada (HRDC)?
Do you have a temporary work permit (Employment Authorization) that allows you to work in Canada for a Canadian employer?

Language Skills

English – Speak
English – Understand
English – Read
English – Write

French – Speak
French – Understand
French – Read
French – Write

Adaptability

Do you, or your spouse, or your common-law partner or your conjugal partner have any close relatives* who are Canadian citizens or Canadian Permanent Residents living in Canada?
	* Close relatives are: parents, grandparents, children, grandchildren, brothers, sisters, aunts, uncles, nieces, nephews, spouse, or common-law partner of either gender. Please note that cousins are NOT included.
What relationship is the person to you?

Have you worked in Canada?
If Yes, What was the job's title, what were your duties and responsibilities and for how many years?

Do you or any of your dependents (spouse, partner, or children) have a police record?
If Yes, please explain

Do you or any of your dependents (spouse, partner, or children) have a significant physical or mental medical condition?
If Yes, please explain

About Your Spouse, Common-law, or Conjugal Partner

Given name(s)
Surname (Family name(s))
Date of birth (day/month/year)

Number of years of full time study since you started school
Number of years of full time training (trades training or apprenticeship, for example)
Number of years of post-secondary study in Canada (if any)

Your Partners Education

Please provide full details of your Spouse or Common-law partner’s education, and the specific name of their degree, below. This information is important, as you earn valuable assessment points that can make the difference to qualify for immigration.
Did your partner graduate from High School?
Total number of years in primary and high school
Please list all Diplomas, Certificates, Degrees, etc. earned and the number of years of study or training taken to earn them. Please only list full-time programs that are at least 1 year in length. Give the specific name of your degree or diploma: i.e. Bachelor's or Master's Degree in Engineering, Certificate in IT, etc.
Total number of years of full time study

Have they worked in Canada?
If Yes, What was the job's title, what were your duties and responsibilities and for how many years?

Confirm e-mail address

Please ensure that all sections above are complete with full details provided. We will reply only to inquiries where full information is provided, and you qualify for immigration to Canada. Thank you for your interest.