General Assessment

Personal Information

Age*

Country of Residence*

Preferred Destination in Canada

Marital Status

Single
Married
Common law partner

Do you have any children under the age of 22?

Your Language Skills (English)

Writing

Reading

Speaking

Listening

Your Language Skills (French)

Writing

Reading

Speaking

Listening

Education and Training

Have you completed high school (secondary school)?*

Have you received any education or training other than high school (secondary school)?

Type of program

Program duration

Did you complete this program?

Yes
No

Location

Your work history

Have you done any paid work during the past 10 years?*

Yes
No

Occupation ( e.g. Chemical Engineer)	Length of work (e.g. 1 yr)	When (e.g. 1 year ago)	Work hours (part time or full time)	Type of job (on payroll or self employed)	Location (inside or outside of Canada)

Starting with your current (or most recent) job, please list all the paid work you have done during the last 10 years:

Express Entry profile

Have you already submitted an Express Entry profile to the Government of Canada within the past 12 months?

Yes
No

Have you already received an Invitation to Apply for permanent residence from the Government of Canada through the Express Entry system?

Canadian job offer

Do you have a written job offer from a Canadian employer?

Occupation

Province or Territory

What is the contract duration?

Work hours

Is this Job Offer supported by a Labour Market Impact Assessment (LMIA)?

Is the job being offered exempt from a LMIA by an international trade agreement (e.g. NAFTA) or a federal-provincial agreement?

Family or Friends in Canada

Do you have a close friend living in the province of Manitoba who is 18 years or older?

Yes
No

Do you have any family members or relatives living in Canada and who are 18 years or older?

Yes
No

Relationship (e.g. my brother)	Residency Status (e.g. PR)	Living in (e.g. Saskatchewan)	Since (e.g. 2 years or longer)

Please list all your and/or your spouse/common-law partner's relatives in Canada

Your Personal Net Worth

Canada Dollar ($)

Net worth is considered for some immigration programs.

Enter Your Contact Information

Name*

First Last

Email*

Phone*

Enter your phone number including the country code and city/area code

Quetion and comments

You may provide additional information that you think would be relevant to your immigration assessment. Would you like to add information at this time?

Additional information:

Immigration Newsletter

Yes, please send me the free Canadian Immigration Newsletter by email.
Yes, I would like to receive timely immigration information and special offers from nextland.ca and trusted partners.

Name

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