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QUESTIONNAIRE / IMMIGRATION ASSESSMENT FORM
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* Indicates required question
Email
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Your email
Name / Last Name: *
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First and last name
Your answer
Date of Birth *
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MM
/
DD
/
YYYY
Sex: *
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Male
Female
Required
Current Country of Residence: *
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Your answer
Nationality: *
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Your answer
Marital Status: *
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Your answer
Education (diplomas or certificates earned in secondary and post-secondary education: university, college and apprenticeship training, abroad or in Canada):
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Your answer
Work experience in the last 10 years (job title, number of hours per week, period, city and country): *
*
Your answer
Language Skills - English ( Speaking; Listening; Reading; Writing) - Level: None, Basic, Moderate, High *
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Your answer
What would you like to do to Canada (visit, study, business, immigrate permanently)? *
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Your answer
How long are you planning to stay in Canada? *
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Your answer
Which Province do you plan to live, or are most interested in? *
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Your answer
Do you have a family member or relatives who is a Canadian citizen or PR, 18 years and older? *
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Your answer
What is your income & net worth, and how much money will you bring to Canada? *
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Your answer
Have you ever been refused any kind of visa, admission, or been ordered to leave Canada? (if yes, please provide details) *
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Your answer
Additional Information (you may provide additional information that you think would be relevant to your immigration assessment) *
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Your answer
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