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US Immigration
Canada Immigration Evaluation Form
Personal Infromation
Title:
Dr.
Mr.
Mrs.
Ms.
Prof.
Gender
M
F
*
First Name:
*
Last Name:
*
Address 1:
*
Address 2:
Country
--Select one--
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Barbuda, Antigua and
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo, The Democratic Republic of the
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Great Britain, United Kingdom
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran, Islamic Republic of
Iraq
Ireland
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Keeling ( Cocos) Islands
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia, The Former Yugoslav Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Malvinas (Falkland Islands)
Mariana Islands, Northern
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia, Federated States of
Moldova, Republic of
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea, DPR
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territory, Occupied
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Polynesia, French
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russian Federation
Rwanda
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Pierre and Miquélon
Saint Vincent and the Grenadines
Samoa
Samoa, American
San Marino
São Tomé and Principé
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Korea, RoK
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan, Province of China
Tajikistan
Tanzania, United Republic of
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican City State, Holy See
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Yugoslavia
Zambia
Zanzibar
Zimbabwe
*
Telephone Number
(
)-(
)-
State:
Zip:
Nationality
*
Age:
--select one--
16 or under
17
18
19
20
Between 21-44
45
46
47
48
49 and over
*
E-mail Addr.
*
Marital status
--select one--
Married
Unmarried
*
This e-mail address will be used for further communications
Work Experience
*
Number of Years:
1
2
3
4+
Education
*
You have completed secondary school(also called high school)
You have completed secondary school (or an educational credential of atleast one year) and at least 12 years of full-time or full-time equivalent studies.
You have completed a one-year post-secondary program and at least 13 years of full-time equivalent studies.
You have completed a two-year post-secondary program and atleast 14 years of full-time or full-time equivalent studies.
You have completed a three-year post-secondary program and atleast 15 years of full-time or full-time equivalent studies.
You have completed a three-year university program and at least 15 years of full-time or full-time equivalent studies.
You have completed a Master's or Ph.D. and atleast 17 years of full-time or full-time equivalent studies.
English and French language ability
Skill Level
Criteria
High Proficiency
You can communicate effectively in most community and workplace situations.You speak,listen, read and write the language very well.
Moderate Proficiency
You can make yourself understood and you understamd what others are saying in most workplace and community situations.You speak,listen,read and write the language well.
Basic or no Profeciency
You do not meet the above criteria for moderate proficiency
English Language
*
High-Proficiency
Moderate Proficiency
Basic or no Proficiency
Read
Write
Listen
Speak
French Language
*
Read
Write
Listen
Speak
Important Additional Information
*
1
Your Accompanying spouse or common-law partner's level of education
Not Applicable
Secondary school (high school) diploma or less
Completed a one or two-year post-secondary program and at least 13 years of education
Completed a three-year post secondary program and has at least 15 years of education
Completed a three-year university degree and has atleast 15 years of education
Completed a Master's or Ph.D. and has at least 17 years of education
2
You or your accompanying spouse or common-law partner has studied in Canada
Not Applicable
No, or less than two years post-secondary education in canada
Completed a post-secondary program of at least two years in Canada since the age of 17
3
You or your accompanying spouse or common-law partner has worked in Canada
Not Applicable
No, or less than one year full-time work in Canada
Worked full-time in Canada for at least one year
4
You or your accompanying spouse or common-law partner has family in Canada
No
Have a parent,grandparent, aunt, uncle, sister, brother, nephew, niece, child or grandchild who is Canadian citizen or permanent resident living in Canada
5
You have a job offer in Canada
No
Have a genuine job offer valid upon entering Canada (if not mentioned/stated under factor 5)
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READ THIS SECTION CAREFULLY ========================== Disclaimer: Please note that this website provides general information only. Information presented does not constitute a consultation.Please consult us on-line by filling out the form on the next page, or contact us by telephone, facsimile or e-mail to schedule a consultation if you have a specific question or are in need of our services.We would be happy to be of aid in your immigration matters. Copyright © 1999-2002 Immigration Desk
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