Preliminary Assessment Questionnaire for Permanent Residence in Canada If your spouse has employment experience, please make an additional copy of this form since he/she can also be considered as the main applicant
Preliminary Assessment Questionnaire
First Name
Last Name
Middle Name
Tel No:
Fax No:
E-mail address
Your Citizenship
Date of Birth(year/month/date)
Marital Status
Ages of Children
WORK EXPERIENCE (Starting with your most recent occupation, describe all your occupations, in as much detail as possible (do not leave any gaps):
A 1. Name of Company 2. What does your company do? 3. Position 4. Full-time, Part-time or Contract based 5. Dates Worked 6. Detailed Description of Duties
B 1. Name of Company 2. What does your company do? 3. Position 4. Full-time, Part-time or Contract based 5. Dates Worked 6. Detailed Description of Duties
C 1. Name of Company 2. What does your company do? 3. Position 4. Full-time, Part-time or Contract based 5. Dates Worked 6. Detailed Description of Duties
D 1. Nameof Company 2. What does your company do? 3. Position 4. Full-time, Part-time or Contract based 5. Dates Worked 6. Detailed Description of Duties
E 1. Name of Company 2. What does your company do? 3. Position 4. Full-time, Part-time or Contract based 5. Dates Worked 6. Detailed Description of Duties
Your Language Ability
What level of education have you successfully completed?
Secondary School College University
Details of your education above (Senior High School, College, University, English courses or Other courses):
Please provide details of any other training, skills or education.
Do you or your spouse have any relatives in Canada? Yes No
If Yes, for each relative state: a. Relationship to you or spouse b. Immigration status in Canada of Relative (i.e. visitor, permanent resident, or citizen)
Have you ever visited, studied or worked in Canada (provide details)? Yes No
If your answer is "Yes", please provide as much detail as possible in the supplied box.
Have you previously applied for immigration to Canada? Yes No
Have you ever been refused an immigrant or visitor visa? Yes No
Have you ever run, managed or controlled a business? Yes No
Please provide details
Business Content
The following questionnaire must be completed by applicants for permanent residency in all business categories. Please ensure that all sections are answered fully and accurately. Please have the form typewritten or completed neatly in block letters
BUSINESS BACKGROUND AND EXPERIENCE
Your full name
1. Business Experience
Name of business
Address
Your position
Your duties and responsibilities
How long did you work in this business
2. Have you ever been involved in a business failure or been associated with a company that closed, went into liquidation, receivership or bankruptcy? If yes provide details
3. Have you had any specialized business training or education. If yes, provide details
1. What is your business plan when you immigrate to Canada
2. What kind of product or service are you selling?
3. Have you ever visited Canada in relation to your business establishment. If so, have you ever met any provincial representatives in regards to your business (when/where/name of rep.)
4. Which province are you planning to start your business? Please explain in detail
5. Please write down your business format: (Self employed, Limited Company, Partnership)
Self Employed
Limited Company
Partnership
Your Name
Telephone Number
6. If you are willing to buy out a company in Canada, please provide the name, address and business content
7. What will be your initial capital investment in your company? (CDN$)
8. Please give a detailed description of your duties in the business
9. Estimated numbers of employees
10. How will your business help the Canadian economy
11. What is your current net worth?
