Free Assessment

PERSONAL DETAILS

Family or Surname

First Name

Initial

Title

Gender

Date of Birth

Place of Birth

Citizenship

Passport No./Date of Issue/Expiry Date

Country of last permanent residence/Since the year

Marital status/ Date of Marriage

Residential Address/Mailing Address

Telephone/Fax-Number/Email

PERSONAL DETAILS OF FAMILY MEMBERS

Family or Surname

First Name

Relation

Date of Birth of Family Members

Country of Birth

Citizenship

Passport No./Date of Issue/Expiry Date

Country of last permanent residence/Since the year

EDUCATIONAL BACKGROUD

Years of Schooling, including College/University

Highest Level of Education Obtained

Any type of apprenticeship? If so, where and for whom?

If you have completed university/college, please answer the questions below. Otherwise, move to “Employment background”

Name of previous university/college, program of study, highest level completed, and dates attended (1)

Name of previous university/college, program of study, highest level completed, and dates attended (2)

Name of previous university/college, program of study, highest level completed, and dates attended (3)

EMPLOYMENT BACKGROUD

Your most recent/current employer, city and country, type of work performed, your official title/position, and dates from and to

Your previous employer, city and country, type of work performed, your official title/position, and dates from and to (1)

Your previous employer, city and country, type of work performed, your official title/position, and dates from and to (2)

Your previous employer, city and country, type of work performed, your official title/position, and dates from and to (3)

What other type of work are you qualified to perform?

What type of work does your spouse do, (if applicable)? What is the highest level of education obtained by her (name of educational institution, type of diploma or certificate)?

FAMILY IN CANADA

Please check if you have any direct relatives in Canada - parents, children, brothers/sisters, grandparents, aunts/uncles

Name

Address

Relationship to you

If you have parents/children or spouse in Canada, are they willing to sponsor you?

NesNo

Sponsor Name

Sponsor Address

Sponsor Relationship to you

FINANCIAL INFORMATION

Please provide the following information in U.S. dollars

How much money do you have in your bank account?

What is the value of your property?

What is the value of your stocks/bonds?

What is the amount of other assets that you have?

How much money do you owe?

What is your total net worth (your assets minus your debts)?