North American Services Center

Assessment Form
Complete your "Free Assessment Form" and find out if you qualify for Migration!
Canada, Australia & New Zealand

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Note: All information you provide will be held in the strictest of confidence. * Fields are mandatory
Which country(ies) are you interested in migrating to?
Check one or more: * Canada Australia New Zealand
Personal Information:
Title Mr. Miss Mrs Dr
First Name *
Last Name *
Current Residence *
Date of Birth *    
Marital Status *
Number of Dependents (Children under 22 years of age)
Current Citizenship: *
Your Contact Information:
Mailing Address (optional)
Telephone
Fax
E-mail Address: *
Education History:
Total number of years of full-time education officially completed *
Number of years of Primary/Elementary School Education
Number of years of Secondary/High School Education
Number of years of College Education
Have you obtained diploma? Yes No
Number of years of University Education
Do you have Degree ?if Yes ,name your degree
Name of the University
Number of years of formal trade apprenticeship / training
Have you taken any additional training/courses in your professional field? Yes
If yes, please list them here
Have you completed post-secondary program in Canada for at least two years? Yes
If yes, please provide details here
Have you completed a post-secondary program of study in Australia? Yes No
If yes, please provide details here
Language Ability:
Rate your ability to communicate in each of these areas as accurately as possible.
English *:

Proficiency

Excellent

Moderate

Basic

None

Speak

Listen

Read

Write

French (Only if you are interested in Canada)

Proficiency

Excellent

Moderate

Basic

None

Speak

Listen

Read

Write

Employment Details, If Applicable:
Your Current occupation *
Total Number of years of experience in this occupation *
Current working place
When did you start? MM YYYY
Fill separately all positions you have occupied since the completion of your formal education (excluding your current position):

Job Title

From

To

  YY

  YY

  YY

  YY

  YY

  YY

  YY

  YY

  YY

  YY

  YY

  YY

Have you worked in Canada in a full-time position for at least one year? Yes
Have you worked in New Zealand in a full-time position for at least one year? Yes
Employment Offer:
Do you have an employment offer from any company in either Canada*, Australia** or New Zealand? Yes
* For Canada, the job offer must first be certified by a Human Resources center in Canada. Your prospective employer before sending you the offer should do this.
** For Australia, it must be a job offer in an occupation included on the Migration Occupations in Demand List.
Your Spouse's details:
Spouse's age
Date of Birth MM YYYY
Spouse's Education
Total number of years of full-time education officially completed
Number of years of Primary/Elementary School Education
Number of years of Secondary/High School Education
Number of years of College Education
Has your spouse obtained diploma? Yes
Number of years of University Education
Has your spouse obtained degree? if Yes name it please
Name of the University
Number of years of formal trade apprenticeship / training
Has your spouse taken any additional training/courses in your professional field? Yes
If yes, please list them here
Has your spouse completed post-secondary program in Canada of at least two years? Yes
If yes, please provide details here
Has your spouse completed a post-secondary program of study in Australia? Yes
If yes, please provide details here
Language Skills
How would you estimate your spouse's ability to communicate in English? None Basic Moderate Excellent
How would you estimate your spouse's ability to communicate in French? None Basic Moderate Excellent
Spouse's Work Experience
Current occupation:
Total Number of years of experience in this occupation
Current working place
When did he/she join? YYYY
Has your spouse worked in Canada in a full-time position for at least one year? Yes

Job Title

From

To

  YY

  YY

  YY

  YY

  YY

  YY

  YY

  YY

  YY

  YY

  YY

  YY

Relatives
Do you or your spouse have any close relatives who are citizens or permanent residents of Canada, Australia or New Zealand, and are currently living there? Yes
If yes, in which country?
Describe the relationship?
Financial Requirements
Are you able to meet the minimum financial requirements for immigration? Yes
Have you ever made a formal application for immigration to Canada, Australia or New Zealand? Yes
If yes, when YYYY
Which country?
What was the outcome?
Your financial situations and your Comments
Please use this space to inform us about your personal net worth (cash, land, saving) and if you have any comments.
How did you hear about North American Services Center? *