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We Help Make Canada Your Home

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: