Pre-application Questionnaire | Skilled Worker

Please note: A family’s eligibility may be assessed on the basis of the qualifications of either spouse. Please complete one form for each spouse.

Fields marked with an * are required



Personal Information

  • First Name:
    *


    Last Name:
    *
  • Address:
    *
  • Home Number:


    Business Number:
  • Email:


    Facsimile Number
  • Current Age:


    Place of Birth:
  • Citizenship:
  • Immigration Status in current country of Residence:

  • Marital Status:

    Never Married: Married: Separated: Divorced: Widowed:

  • Sex

    Male: Female:
  • Number of Children:


    Age(s):

  • Do you or your spouse have any of the following blood relatives in Canada who are either Canadian citizens or permanent residents and who currently reside in Canada: *

  • Mother
    Father
    Grandmother
    Grandfather
    Brother
    Sister
    Aunt
    Uncle
    Niece
    Nephew
    None

  • City and Province of closest blood relative living in Canada:

    City:


    Province:

Education
*

  • Please check the highest level of education completed which applies to you and, where applicable, indicate the name of the institution you attended as well as the name of the diploma or degree you received:

    I have not completed secondary/high school
    I have completed a secondary school educational credential.
    I have completed secondary/high school, but have completed a one-year diploma, trade certificate of apprenticeship AND have a total of 12 years full-time or full-time equivalent studies.
    I have completed a one-year diploma, trade certificate or apprenticeship AND have a total of 13 years full-time or full-time equivalent studies.
    I have completed a two-year diploma, trade certificate or apprenticeship AND have a total of 14 years full-time or full-time equivalent studies.
    I have completed a three-year diploma, trade certificate or apprenticeship AND have a total of 15 years full-time or full-time equivalent studies.
    I have completed a one-year university degree at the Bachelor’s level AND have a total of 13 years of full-time or full-time equivalent studies.
    I have completed a two-year university degree at the Bachelor’s level AND have a total of 14 years of full-time or full-time equivalent studies.
    I have completed two or more university degrees at the Bachelor’s level AND have a total of 15 years of full-time or full-time equivalent studies.
    I have completed a PhD, or Master’s AND have a total of 17 years full-time or full-time equivalent studies.


  • Name of Institution at which Studies completed, including country where studies completed:
  • Name or Type of Diploma or Degree Received and area of specialization:
  • If married, spouse’s highest level of education (based on descriptions above):

Present Occupation

  • Job Title:
    *
  • Name of Employer:

  • Experience

    From (yy/mm/dd):


    To (yy/mm/dd):
  • Job Duties:

Previous Occupation 1

  • Job Title:
  • Name of Employer:

  • Experience

    From (yy/mm/dd):


    To (yy/mm/dd):
  • Job Duties:

Previous Occupation 2

  • Job Title:
  • Name of Employer:

  • Experience

    From (yy/mm/dd):


    To (yy/mm/dd):
  • Job Duties:

Previous Occupation 3

  • Job Title:
  • Name of Employer:

  • Experience

    From (yy/mm/dd):


    To (yy/mm/dd):
  • Job Duties:

Previous Occupation 4

  • Job Title:
  • Name of Employer:

  • Experience

    From (yy/mm/dd):


    To (yy/mm/dd):
  • Job Duties:

Arranged Employment in Canada

  • Do you have arranged employment in Canada which has been validated by a Human Resource Development Canada office through an application made by your prospective employer?

    Yes No

Language Skills
*

  • English

  • Speak
    High Proficiency Moderate Proficiency Basic Proficiency Not At All
  • Read
    High Proficiency Moderate Proficiency Basic Proficiency Not At All
  • Write
    High Proficiency Moderate Proficiency Basic Proficiency Not At All
  • Listen
    High Proficiency Moderate Proficiency Basic Proficiency Not At All

  • French

  • Speak
    High Proficiency Moderate Proficiency Basic Proficiency Not At All
  • Read
    High Proficiency Moderate Proficiency Basic Proficiency Not At All
  • Write
    High Proficiency Moderate Proficiency Basic Proficiency Not At All
  • Listen
    High Proficiency Moderate Proficiency Basic Proficiency Not At All

Assets & Liabilities

  • (1) Please provide an estimate of the total value of assets which you currently hold:
  • (2) Please provide an estimate of the total value of your liabilities
  • (3) Please provide an estimate of the value of the funds which you anticipate being able to transfer to Canada upon your relocation:

Previous Work/Study in Canada

  • (1) Myself or my spouse (if applicable) has previously held a valid Canadian employment authorization and did engage in at least one year of full-time employment in Canada

    Yes No

  • (2) Myself or my spouse (if applicable) has previously held a valid Canadian student authorization and, after the age of seventeen, completed a two-year program of full-time study at a post-secondary institution in Canada

    Yes No

Admissibility

  • Do you or any other member of your family have *



    (a) any past or present medical conditions...
  • (b) any past criminal history in Canada or any other country...
  • (c) any past Canadian immigration history...

Contacting Us

  • Please Enter Email Address:
    *

  • How were you referred to us ?



    Please Specify if Other


<< Print This Form >>