Please complete the following:
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Personal Information
Last Name:*
First Name:*
Middle Name:
 
Street Address:
City:
Province/State:
Country:
Postal Code/Zip:
 
Home Phone Number:
Office Phone Number:
Fax Number:
e-Mail:*
 
Age
Please Choose One:
 
Marital Status
Please Choose One:
 
Country of Citizenship:
Country of Birth:
Spouse/Partner's Country of Birth:
Spouse/Partner's Country of Citizenship:
Ages of Children:
 
Education
Please select one of the following:

University:

PhD, or Master's, AND at least 17 years of full-time or full-time equivalent study.

Two or more university degrees at the Bachelor's level AND at least 15 years of full-time or full-time equivalent study.

A two-year university degree at the Bachelor's level AND at least 14 years of full-time or full-time equivalent study.

A one-year university degree at the Bachelor's level AND at least 13 years of full-time or full-time equivalent study.

Trade or Non-university Certificate or Diploma:

A three-year diploma, trade certificate or apprenticeship AND at least 15 years of full-time or full-time equivalent study.

A two-year diploma, trade certificate or apprenticeship AND at least 14 years of full-time or full-time equivalent study.

A one-year diploma, trade certificate or apprenticeship AND at lease 13 years of full-time or full-time equivalent study.

A one-year diploma, trade certificate or apprenticeship AND at least 12 years of full-time or full-time equivalent study.

Secondary School Educational Credential.

Completion of secondary (high) school.
 
Language Ability
English Read/Write/Speak:
French Read/Write/Speak:
 
Work Experience
Please list your total number of years of work experience, indicate whether this is full-time or part-time experience:
Please describe your work experience below (attach a resume if you like) by listing the job title, a brief description of your duties, and the dates of employment:
If you have ever owned a business, please describe your business experience in detail including the dates of business ownership, the percentage of business ownership you held, and the role you played in the business (ie. Manager or passive shareholder):
 
Spouses Education and Work Experience
If you are married or living common-law with a partner, please describe your spouse's level of education and his or her work or business ownership experience:
 
Work/Study History in Canada
Have you or your spouse/partner ever worked or studied in Canada for at least 2 years? If so, please provide details:
 
Family Relationships
Do you or your spouse/partner have any relatives living in Canada or the United States? If so, please outline their relationship to you and their country of residence:
 
Job Offer in Canada or the U.S.
Do you or your spouse/partner have a current job offer from a Canadian or U.S. employer? If so, please provide the details of the offer:
 
Settlement funds available
Please list the amount of money you have available to transfer to Canada or the United States (in Canadian or U.S. currency):
 
Inadmissibility Issues
Criminal or Medical History:
 
Preferred Destination
Preferred country of destination:
Do you have an offer of employment from your preferred country of destination? Yes    No
 
Relative Information
1. Do you have any relatives in Canada? Yes    No
2. Do you have any relatives in the U.S.? Yes    No
3. Do you have a spouse or fiance(e) in Canada or the U.S.? Yes    No
4. Were either of your parents Canadian citizens? Yes    No
5. Were either of your parents U.S. citizens? Yes    No
 
Please ask us any specific questions in this section:
 







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