Culture Connect International Ltd., Regina Canada.

{ Regina Time: Monday 20th January 2025 }

ONLINE ASSESSMENT FORM

CHOOSE YOUR CATEGORY

What is your Marital Status?

Any Relatives in Canada?

What is your Age?

What is your First Name?

What is your Family Name?

What is your Email Address?

[Our consultant will contact you through this email address]

YOUR LANGUAGE PROFICIENCY

YOUR EDUCATION

Highest Degree Completed

Your Field of Study

Total Years of Full-Time Study

years from Grade 1 (childhood) to Present

YOUR SPOUSE'S EDUCATION

Highest Degree Completed

Total Years of Full-Time Study

years from Grade 1 (childhood) to Present

YOUR WORK EXPERIENCE

Full Job Title	Number of Years



You may wish to paste your CV (optional) or add further employment details below:

ADAPTABILITY

Since the age of 17, have you or your spouse studied in Canada for at least 2 years?	Yes	No
Have you or your spouse worked in Canada for at least one year?	Yes	No

ARRANGED EMPLOYMENT

Do you have arranged employment in Canada or are your currently working in Canada?

Yes

CONTACT INFORMATION

Phone Number(s)

Full Address