Client Assessment Form
CONTACT INFORMATION
Your Full Legal Name (As shown on your passport)
Address
What country do you live in now?
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua & Deps
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Rep
Chad
Chile
China
Colombia
Comoros
Congo
Congo {Democratic Rep}
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland {Republic}
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea North
Korea South
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar, {Burma}
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russian Federation
Rwanda
St Kitts & Nevis
St Lucia
Saint Vincent & the Grenadines
Samoa
San Marino
Sao Tome & Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad & Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Contact
PERSONAL INFORMATION
Date of Birth
Place of Birth
What country were you born in?
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua & Deps
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Rep
Chad
Chile
China
Colombia
Comoros
Congo
Congo {Democratic Rep}
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland {Republic}
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea North
Korea South
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar, {Burma}
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russian Federation
Rwanda
St Kitts & Nevis
St Lucia
Saint Vincent & the Grenadines
Samoa
San Marino
Sao Tome & Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad & Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Citizenship
Marital Status
Select Your Current Status
Never Married
Married
Engaged
Living with your Same Sex Partner [FOR MORE THAN 1 YEAR]
Living with your Common Law Partner [FOR MORE THAN 1 YEAR]
Separated
Divorced
Widowed
YOUR EDUCATION DETAILS
Provide the Highest Level of Education that You Have Graduated or Passed
Select Your Highest Level Qualification
None
Graduated from Secondary School
1 year College Diploma or Certificate
2 year College Diploma or Certificate
3 year College Diploma or Certificate
4 year College Diploma or Certificate
Trade or Apprentiship Certificate
1 year University credential
2 year University credential
3 year University credential
4 year University credential
Masters Degree
PhD
Provide the Second Highest Level of Education that You Have Graduated or Passed
Select Your Second Highest Level Qualification
Graduated from Secondary School
1 year College Diploma or Certificate
2 year College Diploma or Certificate
3 year College Diploma or Certificate
4 year College Diploma or Certificate
Trade or Apprentiship Certificate
1 year University credential
2 year University credential
3 year University credential
4 year University credential
Masters Degree
PhD
Please Describe Your COMPLETED Accreditations (in example format shown below; Date: Course: Institution:)
Date: Sep-2019 to Jun-2021 - Course: Care101 - Institution: Care College, Manila
Date: Feb-2021 to Sep-2021 - Course: Nursing – Institution… etc.
YOUR ENGLISH LANGUAGE ABILITY
English - Speaking
Select Your English Speaking Ability
Fluent - (can converse without limitation)
Well - (have limited vocabulary but people understand)
With Difficulty
None
English - Reading
Select Your English Reading Ability
Fluent - (can read without limitation)
Well - (have limited vocabulary but can look up new words)
With Difficulty
None
English - Writing
Select Your English Writing Ability
Fluent - (can write without limitation)
Well - (have limited vocabulary but can look up new words)
With Difficulty
None
English - Listening/Understanding
Select Your English Listening Ability
Fluent - (can understand without limitation)
Well - (have limited vocabulary but understand most words)
With Difficulty
None
YOUR FRENCH LANGUAGE ABILITY
French - Speaking
Select Your French Speaking Ability
Fluent - (can converse without limitation)
Well - (have limited vocabulary but people understand)
With Difficulty
None
French - Reading
Select Your French Reading Ability
Fluent - (can read without limitation)
Well - (have limited vocabulary but can look up new words)
With Difficulty
None
French - Writing
Select Your French Writing Ability
Fluent - (can write without limitation)
Well - (have limited vocabulary but can look up new words)
With Difficulty
None
French - Listening/Understanding
Select Your French Listening Ability
Fluent - (can understand without limitation)
Well - (have limited vocabulary but understand most words)
With Difficulty
None
If you have taken a language test in the last 3 years, please provide results in each of the 4 categories below
YOUR WORK HISTORY
Your Employment Details for the Past 10 Years
YOUR SPOUSE OR PARTNER'S DETAILS (if any)
Your Spouse or Partner's Legal Name (As shown on their passport)
Spouse or Partner's Personal Information
Date of Birth
Spouse or Partner's Place of Birth
What country was your spouse or partner born in?
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua & Deps
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Rep
Chad
Chile
China
Colombia
Comoros
Congo
Congo {Democratic Rep}
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland {Republic}
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea North
Korea South
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar, {Burma}
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russian Federation
Rwanda
St Kitts & Nevis
St Lucia
Saint Vincent & the Grenadines
Samoa
San Marino
Sao Tome & Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad & Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Spouse or Partner's Citizenship
SPOUSE OR PARTNER'S EDUCATION DETAILS
Provide the Highest Level of Education that Your Spouse or Partner Has Graduated or Passed
None
Graduated from Secondary School
1 year College Diploma or Certificate
2 year College Diploma or Certificate
3 year College Diploma or Certificate
4 year College Diploma or Certificate
Trade or Apprentiship Certificate
1 year University credential
2 year University credential
3 year University credential
4 year University credential
Masters Degree
PhD
Provide the Second Highest Level of Education that Your Spouse or Partner Has Graduated or Passed
Select Spouse or Partner's Second Highest Level Qualification
Graduated from Secondary School
1 year College Diploma or Certificate
2 year College Diploma or Certificate
3 year College Diploma or Certificate
4 year College Diploma or Certificate
Trade or Apprentiship Certificate
1 year University credential
2 year University credential
3 year University credential
4 year University credential
Masters Degree
PhD
Please Describe Your Spouse or Partner's Accreditations; Subject - Institution - Year of Graduation
YOUR SPOUSE OR PARTNER'S ENGLISH LANGUAGE ABILITY
English - Speaking
Select Your Spouse or Partner's English Speaking Ability
Fluent - (can converse without limitation)
Well - (have limited vocabulary but people understand)
With Difficulty
None
English - Reading
Select Your Spouse or Partner's English Reading Ability
Fluent - (can read without limitation)
Well - (have limited vocabulary but can look up new words)
With Difficulty
None
English - Writing
Select Your Spouse or Partner's English Writing Ability
Fluent - (can write without limitation)
Well - (have limited vocabulary but can look up new words)
With Difficulty
None
English - Listening/Understanding
Select Your Spouse or Partner's English Listening Ability
Fluent - (can understand without limitation)
Well - (have limited vocabulary but understand most words)
With Difficulty
None
YOUR FRENCH LANGUAGE ABILITY
French - Speaking
Select Your Spouse or Partner's French Speaking Ability
Fluent - (can converse without limitation)
Well - (have limited vocabulary but people understand)
With Difficulty
None
French - Reading
Select Your Spouse or Partner's French Reading Ability
Fluent - (can read without limitation)
Well - (have limited vocabulary but can look up new words)
With Difficulty
None
French - Writing
Select Your Spouse or Partner's French Writing Ability
Fluent - (can write without limitation)
Well - (have limited vocabulary but can look up new words)
With Difficulty
None
French - Listening/Understanding
Select Your Spouse or Partner's French Listening Ability
Fluent - (can understand without limitation)
Well - (have limited vocabulary but understand most words)
With Difficulty
None
If your spouse or partner has taken a language test in the last 3 years, please provide results in each of the 4 categories below
YOUR SPOUSE OR PARTNER'S WORK HISTORY
Your Spouse or Partner's Employment Details for the Past 10 Years
YOUR CHILDREN (if any)
Number of Children You and Your Spouse/Partner Have
Select the Number of Children
none
1
2
3
4
5
6
Child #1
Child #2
Child #3
Child #4
Child #5
Child #6
MISCELLANEOUS
If you or your spouse/partner have any relatives already living in Canada, please provide details
Have you ever visited Canada before?
Select your type of visit
Never
As a visitor
Business trip
Worked legally in Canada
Studied at a Canadian school, college, or university
If you or your spouse/partner have been charged or convicted of any offense in the last 10 years please provide details, if there are none enter "None".
Thank you for providing your details. We shall respond to you within 5 business days, however if you require more urgent attention (e.g. impending visa deadline, etc.), please also send us an email at info@candimm.ca for a quicker written response.
The information provided within this assessment is confidential and shall only be shared as necessary, by Candi Immigration staff with Canadian Immigration personnel (IRCC - Immigration, Refugee & Citizenship Canada) for the purposes of an immigration application or appeal on behalf of the main applicant, spouse, partner, or any dependant child.
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