Untitled Document

Assessment for Sponsoring Family Members or a Fiancée

1.Information about Sponsor

Ms. Mr.

Last Name:

First Name:

E-mail:
We will respond to the email address entered here

Phone:

Age: Marital Status: Country of Citizenship:

Country , City of Residence:

Number of People in Household:

Total Household Income:

Education Level:

Work History:

2.Information about Relatives Seeking Permanent Status in Canada

Number of applicants seeking to be sponsored:

Applicant (1)

Ms. Mr.

Last Name:

First Name:

E-mail:

Phone:

Age: Marital Status: Country of Citizenship:

Country and City of Residence:

What is your relation
to the sponsor?

       Parent
       Grandparent
       Brother or Sister
       Aunt/Uncle
       Cousin
       Son or Daughter
       Spouse/Fiancée
       Other

If you selected OTHER, Specify:

Please indicate your abilities in both the English and French languages, as follows:

FLUENT: Very good command of the language in a range of social and work situations, and no difficulty 
communicating in a professional capacity. 
WELL: Can communicate reasonably well about personal and familiar things. 
 WITH DIFFICULTY: Command of just a few basic words.

	Reading	Writing	Speaking	Listening
English:*
French:*

Education Level:

Work Experience:

Applicant (2)

Ms. Mr.

Last Name:

First Name:

E-mail:

Phone:

Age: Marital Status: Country of Citizenship:

Country and City of Residence:

What is your relation
to the sponsor?

       Parent
       Grandparent
       Brother or Sister
       Aunt/Uncle
       Cousin
       Son or Daughter
       Spouse/Fiancée
       Other

If you selected OTHER, Specify:

Please indicate your abilities in both the English and French languages, as follows:

FLUENT: Very good command of the language in a range of social and work situations, and no difficulty 
communicating in a professional capacity. 
WELL: Can communicate reasonably well about personal and familiar things. 
WITH DIFFICULTY: Command of just a few basic words.

	Reading	Writing	Speaking	Listening
English:*
French:*

Education Level:

Work Experience:

Applicant (3)

Ms. Mr.

Last Name:

First Name:

E-mail:

Phone:

Age: Marital Status: Country of Citizenship:

Country and City of Residence:

What is your relation
to the sponsor?

       Parent
       Grandparent
       Brother or Sister
       Aunt/Uncle
       Cousin
       Son or Daughter
       Spouse/Fiancée
       Other

If you selected OTHER, Specify:

Please indicate your abilities in both the English and French languages, as follows:

FLUENT: Very good command of the language in a range of social and work situations, and no difficulty 
communicating in a professional capacity. 
WELL: Can communicate reasonably well about personal and familiar things. 
WITH DIFFICULTY: Command of just a few basic words.

	Reading	Writing	Speaking	Listening
English:*
French:*

Education Level:

Work Experience:

Applicant (4)

Ms. Mr.

Last Name:

First Name:

E-mail:

Phone:

Age: Marital Status: Country of Citizenship:

Country and City of Residence:

What is your relation
to the sponsor?

       Parent
       Grandparent
       Brother or Sister
       Aunt/Uncle
       Cousin
       Son or Daughter
       Spouse/Fiancée
       Other

If you selected OTHER, Specify:

Please indicate your abilities in both the English and French languages, as follows:

FLUENT: Very good command of the language in a range of social and work situations, and no difficulty 
communicating in a professional capacity. 
WELL: Can communicate reasonably well about personal and familiar things. 
WITH DIFFICULTY: Command of just a few basic words.

	Reading	Writing	Speaking	Listening
English:*
French:*

Education Level:

Work Experience:

3) Additional Information

An automated response acknowledging receipt of your form will be emailed to you immediately. If you do not receive the acknowledgement, then the email address provided by you is invalid and we will be unable to respond to your assessment request.