Free Employee Immigration Evaluation Questionnaire

Simply complete the form below and submit it to CdnWork using the button at the bottom of the form. Within one week of receiving your completed questionnaire, we will advise you of your chances for immigrating to Canada, as well as the cost of our services.

NURSES:
Are you a qualified nurse? If so, download, print and complete the Nurse Resume Template instead of the online form below.

The Registered Nurses Association of British Columbia (RNABC) English language proficiency requirements are also available. For details please read their RNABC English Tests Fact Sheet.

NOTE: You will require Adobe Acrobat Reader to open the file. If you do not have this reader, click here to download it for free.

PHARMACISTS:
Are you a qualified pharmacist? If so, download, print and complete the Pharmacist Resume Template instead of the online form below.

The College of Pharmacists of BC Council requires successful completion of the College of Pharmacists of B.C. English Language Proficiency (ELP) Assessment Interview or an approved option. For details of their requirements please read their English Language Proficiency Requirements document.

 
FORM NAVIGATION INSTRUCTIONS

Use the TAB button or your MOUSE to navigate within this form. Using the ENTER button will SUBMIT the form. If no cursor appears in the first line, click "TAB" to make it appear in the first box.

YOU
 Contact Information:
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Last name
First name
Middle name(s)
Sex Male  Female
E-mail address
Telephone
Facsimile
Street address
City
Country
Postal code
Birthdate (dd/mm/yyyy):
(Example: 14/03/1975)
Present Occupation:
Citizenship:
Marital Status: Single 
Engaged 
Married
Separated 
Divorced 
Widowed 

 English Language Ability:
spacer Speak   Read   Write  
Fluently
      
Well
      
With Difficulty
      

Have you written an English test?
  Yes     No
If so, which English test?  

 French Language Ability:
spacer Speak   Read   Write  
Fluently
      
Well
      
With Difficulty
      

 Other Languages:
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Please Specify:

 Education:

Primary  Secondary  University

 Degrees, Diplomas or Certificates:

First Program Start Date:
(dd/mm/yyyy)
First Program Finish Date:
(dd/mm/yyyy)
Name of Diploma,
Degree or Certificate Granted:

Second Program Start Date:
(dd/mm/yyyy)
Second Program Finish Date:
(dd/mm/yyyy)
Name of Diploma,
Degree or Certificate Granted:
Third Program Start Date:
(dd/mm/yyyy)
Third Program Finish Date:
(dd/mm/yyyy)
Name of Diploma,
Degree or Certificate Granted:
Additional Degrees,
Diplomas or
Certificates:

 Professional Training or Apprenticeship:

Start Date (dd/mm/yyyy):
Finish Date (dd/mm/yyyy):
Title or Description
of Training:

Start Date (dd/mm/yyyy):
Finish Date (dd/mm/yyyy):
Title or description
of Training:

Start Date (dd/mm/yyyy):
Finish Date (dd/mm/yyyy):
Title or Description
of Training:

Title or Description
of Other Training:

 Personal Information:

Type of work you plan
to do in Canada:
Do you have an offer
of employment in Canada?
 Yes  No
If yes, is the offer:
 Written  Oral  Both
Amount of money
you would be
bringing to Canada:
 Arrival:
Later:
Where do you plan
to reside in Canada?
Have you ever visited
Canada before?
 Yes  No
If yes, how long
was your stay?
Have you ever visited
Quebec before?
 Yes  No
If yes, how long
was your stay?
Do you have friends
and/or relatives
in Canada?
 Yes  No
If yes, specify: name,
address and occupations:
Have you previously applied
for admission into Canada?
 Yes  No
Have you been convicted
of or are you currently
charged with any crime
or offense in any country?
 Yes  No
Do you suffer from any
communicable or chronic
diseases? (exclude common
colds or influenza)
 Yes  No

YOUR SPOUSE

 Contact Information:
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Last name
First name
Middle name(s)
Birthdate (dd/mm/yyyy):
Present Occupation:
Citizenship:

 English Language Ability:
spacer Speak   Read   Write  
Fluently
      
Well
      
With Difficulty
      

 French Language Ability:
spacer Speak   Read   Write  
Fluently
      
Well
      
With Difficulty
      

 Other Languages:
spacer

Please Specify:

 Education:

Primary  Secondary  University

 Degrees, Diplomas or Certificates:

First Program Start Date:
(dd/mm/yyyy)
First Program Finish Date:
(dd/mm/yyyy)
Name of Diploma,
Degree or Certificate Granted:

Second Program Start Date:
(dd/mm/yyyy)
Second Program Finish Date:
(dd/mm/yyyy):
Name of Diploma,
Degree or Certificate Granted:

Third Program Start Date:
(dd/mm/yyyy)
Third Program Finish Date:
(dd/mm/yyyy)
Name of Diploma,
Degree or Certificate Granted:

Additional Degrees,
Diplomas or
Certificates:

 Professional Training or Apprenticeship:

Start Date (dd/mm/yyyy):
Finish Date (dd/mm/yyyy):
Title or description
of Training:

Start Date (dd/mm/yyyy):
To (dd/mm/yyyy):
Title or description
of Training:

Start Date (dd/mm/yyyy):
Finish Date (dd/mm/yyyy):
Title or Description
of Training:

Title or Description
of Other Training:

YOUR DEPENDANT(S)

 Contact Information (1):
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Last name
First name
Middle name(s)
Sex
 Male  Female
Birthdate (dd/mm/yyyy):

 Contact Information (2):
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Last name
First name
Middle name(s)
Sex
 Male  Female
Birthdate (dd/mm/yyyy):

 Contact Information (3):
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Last name
First name
Middle name(s)
Sex
 Male  Female
Birthdate (dd/mm/yyyy):

spacer

Additional Dependents:

OTHER INFORMATION

 Additional Comments:
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Please provide us with any additional information about you
or your dependents which you think will be helpful
for us to assess your qualifications:

 Preferred Communication:

Method:

 Best Time to Contact You:

From: 
To: