Confidential Intake

Canadian Immigration
Eligibility Assessment

Complete this 14-section form to receive a tailored assessment of your eligibility for every active Canadian immigration pathway. Your responses are saved automatically as you progress.

Estimated time: 20 to 30 minutes · Data: stored locally in your browser until you submit · Required: truthful, complete responses

Section 01

Personal Information

Basic identification details. Use names exactly as they appear on your passport.

Surname (Family Name) *

Given Name(s) *

Other Names Used (maiden, alias)

Date of Birth *

Place of Birth (City, Country) *

Country of Citizenship *

Second Citizenship (if any)

Country of Current Residence *

Residential Address

Phone (with country code) *

WhatsApp (if different)

Email Address *

Marital Status *

Passport Number

Passport Expiry

Section 02

Family Composition

Details on spouse and any dependent children. Skip the spouse block if not applicable.

Spouse / Common-Law Partner

Full Name

Date of Birth

Citizenship

Highest Education

Current Occupation

English / French Level

Will your spouse accompany you to Canada?

Yes No N/A

Dependent Children

Add a row for each child under age 22, or older if dependent due to disability.

Section 03

Canadian Connections

Existing ties to Canada strengthen most pathways and qualify you for additional points.

Do you have relatives who are Canadian citizens or Permanent Residents?

Yes No

If yes, provide details (name, relationship, province, status, year)

Previous Canadian Visits / Studies / Work

List dates, purpose, and location

Previous Visa Applications

Have you ever applied for a Canadian visa or permit before?

Yes No

If yes, provide type, date, and outcome (approved / refused). Refusals must be disclosed.

Section 04

Language Proficiency

English and French test results. Approved tests only.

English

Which test have you taken?

IELTS General CELPIP General PTE Core None / Not yet

Test Date

Listening

Reading

Writing

Speaking

Overall (CLB)

French

Which test have you taken?

TEF Canada TCF Canada None / N/A

Test Date

Overall (NCLC / CLB)

Section 05

Education

List your highest qualification first. Include all post-secondary studies.

Educational Credential Assessment (ECA)

Status

Completed In progress Not started Not required

Issuing Body & Date (if completed)

Section 06

Work Experience

Paid work experience over the last 10 years. Start with most recent.

Total years of full-time skilled work experience

Section 07

Job Offer & Provincial Interest

A valid Canadian job offer significantly accelerates most pathways.

Do you hold a valid job offer from a Canadian employer?

Yes No In discussion

If yes, provide employer, city/province, job title, and offer details

Provincial Preferences

Tick all provinces you are open to settling in.

Are you open to settling in a rural or small community?

Yes No Open to discussion

Section 08

Financial Resources

Most economic pathways require proof of settlement funds. Provide amounts in CAD where possible.

Liquid Savings (cash / bank, CAD)

Investments (CAD)

Real Estate Equity (CAD)

Business Equity (CAD)

Annual Income — last 12 months (CAD)

Estimated Total Net Worth (CAD)

Willingness to invest capital in a Canadian business

Under CAD 100K CAD 100K – 500K CAD 500K + No

Section 09

Business & Entrepreneurial Profile

For business immigration pathway eligibility.

Have you owned or managed a business in the last 5 years?

Yes — owner Yes — senior manager No

If yes, provide business name, sector, role, ownership %, employees

Do you have a venture or idea to bring to Canada?

Yes No Exploring

If yes, briefly describe the concept and stage

Section 10

Admissibility & Background

Honest disclosure here is critical. Concealment is grounds for refusal and bans.

Do you have any criminal record or pending charges in any country?

Yes No

If yes, provide details

Do you or any dependent have a serious medical condition requiring ongoing care?

Yes No

If yes, briefly describe

Refused entry, deported, or removed from any country?

Yes No

If yes, provide details

Section 11

Pathway Interest

Tick every Canadian immigration pathway you have considered or want to explore.

Section 12

Goals, Timeline & Motivation

Helps align pathway recommendations to your priorities.

Preferred relocation timeline

Family relocation plan

Whole family at once Phased relocation Initially solo Undecided

Estimated budget for the immigration process (CAD)

Section 13

Additional Information

Anything else relevant: French heritage, professional licences, scholarships, awards, prior consultations, special skills, etc.

Section 14

Declaration & Consent

Please read and confirm both statements before submission.

I declare that the information provided in this form is true, complete, and accurate to the best of my knowledge. I understand that providing false or misleading information may result in refusal of services and refusal of immigration applications.

I authorise the assigned consultant to use my information to assess my eligibility and prepare an immigration strategy. No application will be submitted on my behalf without my express written consent and a signed retainer.

Full Name (typed signature) *

Date *

Final Step

Review & Submit

Review the summary below. Download a copy for your records, then submit to your consultant.

Canadian ImmigrationEligibility Assessment

Personal Information

Family Composition

Spouse / Common-Law Partner

Dependent Children

Canadian Connections

Previous Canadian Visits / Studies / Work

Previous Visa Applications

Language Proficiency

English

French

Education

Educational Credential Assessment (ECA)

Work Experience

Job Offer & Provincial Interest

Provincial Preferences

Financial Resources

Business & Entrepreneurial Profile

Admissibility & Background

Pathway Interest

Goals, Timeline & Motivation

Additional Information

Declaration & Consent

Review & Submit

Canadian Immigration
Eligibility Assessment