IMMIGRATION ASSESSMENT FORM

DATE: ________________

NAME (in PinYin): _______________________________ (in Chinese): ____________
DATE OF BIRTH: ______________SEX: ________MARITAL STATUS: __________
HOME ADDRESS: ______________________________________________________
_______________________________________________________________________
MAILING ADDRESS (if different from above): ________________________________
_______________________________________________________________________
HOME PHONE NUMBER: _____________________ FAX: _____________________
WORK PHONE: _____________________CELLULAR PHONE: _________________
EMAIL: ________________________________________________________________

EDUCATION: (Starting from high school)

From
M/Y To
M/Y School Name City / Town / Province Diploma / Certificate

WORK EXPERIENCE: (Since 18 years old)

From
m / y To
m / y Company Name City / Town / Province Title / Position

LANGUAGE TEST:

ENGLISH: TOEFL: ______ IELTS: ______ FRENCH: TEF: ______

HAVE BEEN IN CANADA? How long: _______ What for: _______________

RELATIVES IN CANADA? Relation to you: _________ Where: ____________

Remark: Once completed, please fax to 001-416-2926340

CONFIDENTIAL ONCE COMPLETED