Skilled Worker Class Form

Please Fill Out The Following Form

1 - PERSONAL INFORMATION
Name First Last
Sex: Male Female
Date of Birth: / MM / DD YYYY
Nationality:
Country Of Birth
City Of Birth:
Other Citizenship or Residence? Yes No
If Yes, Specify The Country:
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Phone Number Including Country And Area Code
Email
2 - MARITAL INFORMATION
What Is Your Marital status ?
Spouse's Date of Birth: / MM / DD YYYY
2 (A) - Give the number of years of school the spouse successfully completed for each or the following levels of education.
Primary
Secondary
Secondary Level Vocational Training
Trade School
College
University
Master Yes
Doctorate Yes
(If other please specify)
Spouse's field of study:
Number of Dependent Children (22 Years of age and under)
2 (B) - Spouse's Ability in English and French
Read English
Write English
Speak English
Listen English
Lire Français
Écrire Français
Parler Français
Comprendre Français
3 - EDUCATIONAL PROFILE
Your Ability in English and French
Read English
Write English
Speak English
Listen English
Lire Français
Écrire Français
Parler Français
Comprendre Français
Total Years of education:
(Including Primary, Secondary, and Post Secondary)
Give the number of years of school you successfully completed for each of the following levels of education.

3 (A) - Certificate 1 :
Primary School
Secondary School
Secondary Level Vocational Training
Trade School
College
University
Master Yes
Doctorat Yes
Others
Field of study:
Date Started: (Month, Date, Year)
Date of Graduation: (Month, Date, Year)
Name of Institution:
City:
Country:
3 (B) - Certificate 2 :
Total Years of education:
Secondary Level Vocational Training
Trade School
College
University
Master Yes
Doctorat Yes
Others
Field of study:
Date Started: (Month, Date, Year)
Date of Graduation: (Month, Date, Year)
Name of Institution:
City:
Country:
3 (C) - Certificate 3 :
Total Years of education:
Secondary Level Vocational Training
Trade School
College
University
Master Yes
Doctorat Yes
Others
Field of study:
Date Started: (Month, Date, Year)
Date of Graduation: (Month, Date, Year)
Name of Institution:
City:
Country:
4 : EMPLOYMENT HISTORY
4 (A) - Name of Company/Organization:
Job Title:
From: (Month, Date, Year)
To: (Month, Date, Year)
Employment Status:
Number of Hours Worked per Week:
Do You Presently Still Work at this Company? Yes No
Employment Duties:
City:
Country:
4 (B) - Name of Company/Organization:
Job Title:
From: (Month, Date, Year)
To: (Month, Date, Year)
Employment Status:
Number of Hours Worked per Week:
Do You Presently Still Work at this Company? Yes No
Employment Duties:
City:
Country:
4 (C) - Name of Company/Organization:
Job Title:
From: (Month, Date, Year)
To: (Month, Date, Year)
Employment Status:
Number of Hours Worked per Week:
Do You Presently Still Work at this Company? Yes No
Employment Duties:
City:
Country:
If you have additional experience, please include in the Additional Comments Box below
5 - OTHER
Relationship to Closest Blood Relative in Canada (Canadian Citizen or Landed Immigrant):
Relative Province of Residence
Personal Net worth (CAD$):
Do you currently have an offer of employment from a Canadian employer? Yes No
If your answer to the above question is "Yes" provide details here:
6 - GENERAL QUESTIONS

Have you or spouse/common law partner or dependent children ever:
Been convicted of, or are you currently charged with, on trial, or party to a crime or offence, or subject of any criminal proceedings in any country?
Yes No
Previously sought refugee status in Canada or applied for a Canadian immigrant or permanent resident visa or visitor or temporary resident visa?
Yes No
Been refused refugee status in, or an immigrant or permanent resident visa or visitor or temporary resident visa, Canada or any other country, or have been refused a Certificat de sélection du Québec (CSQ) to Quebec?
Yes No
Been refused admission to, or ordered to leave, Canada or any other country?
Yes No
Been involved in an act of genocide, a war crime or in the commission or a crime against humanity?
Yes No
Been refused admission to, or ordered to leave Canada or any other country?
Yes No
Used, planned or advocated the use of armed struggle or violence or reach political, religious or social objectives? Yes No
Been associated with a group that used, uses, advocated or advocates the use of armed struggle or violence to reach political, religious or social objectives? Yes No
Been member of an organization that is or was engaged in an activity that is part of a pattern of criminal activity?
Yes No
Been detained or in jail?
Yes No
Had any serious disease or physical or mental disorder?
Yes No
If your answer to any of these questions is YES, provide details below
Please inform us how did you learn about us Search Engine (please specify name & keywords used for the search) Newspaper or Magazine (please specify) Newsgroup (please specify) General Recommendation
Comments Or Specifications For Our Team ???:

Skilled Worker Class Form

Skilled Worker Class Form

1 - PERSONAL INFORMATION

2 - MARITAL INFORMATION

2 (A) - Give the number of years of school the spouse successfully completed for each or the following levels of education.

2 (B) - Spouse's Ability in English and French

3 - EDUCATIONAL PROFILE

Your Ability in English and French

Give the number of years of school you successfully completed for each of the following levels of education. 3 (A) - Certificate 1 :

3 (B) - Certificate 2 :

3 (C) - Certificate 3 :

4 : EMPLOYMENT HISTORY

5 - OTHER

6 - GENERAL QUESTIONS Have you or spouse/common law partner or dependent children ever:

Give the number of years of school you successfully completed for each of the following levels of education.

3 (A) - Certificate 1 :

6 - GENERAL QUESTIONS

Have you or spouse/common law partner or dependent children ever: