First Name:

Family Name:

Address:


City:                                         Province/ Region

Country:

Tel:

Fax:

Email:

Age:


Level of Education:

Occupation:

Educational/Training Factor (EFT): (We�ll help you determine your ETF)

Arranged Employment (if any):

Work Experience:

Language Ability:

Mother tongue:

Knowledge of English
  
                                    Fluently          Well       With difficulty/Not at all
Speak

Read

Write

Knowledge of  French 
                                          Fluently          Well       With difficulty/Not at all
Speak

Read

Write

Demographic Factor: Automatic 8 points awarded to each applicant.

Relative in Canada?:

If yes, nature of relationship:

When do you plan to immigrate to Canada:



Additional comments:


GUARANTEE POLICY: After we have helped you do the assessment, if you are able to obtain 65% or more, we will be ready to guarantee your successful acceptance as an independent immigrant or your money back.

Free Point Assessment
(Independent Immigrant)
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