Evaluation form - Business Applicant

(Self-employed, Entrepreneur or Investor) CONFIDENTIAL

NAME * Title First Last Suffix
Sex * Male Female
Civil status * Single Married Divorced Separated Other
If you have a spouse, fiance, de facto spouse or in a marital relationship, please complete the section for the spouse below.
Date of Birth * / DD / MM YYYY
CITIZENSHIP *
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Phone
Email address *

Please make sure to indicate a valid email address so that we may reply back to you.
SECONDARY AND POST SECONDARY EDUCATION 1st Diploma or Degree Name of Diploma or Degree completed in full *
Dates of study (From/to) *
Name of educational institution - City and Country of study *
2nd Diploma or Degree Name of diploma or Degree (completed)
Dates of study (From/to)
Name of educational institution - City and Country of study
3rd Diploma or Degree Name of Diploma or Degree completed
Dates of study (From/To)
Name of educational institution - City and country of study
MANAGEMENT EXPERIENCE or BUSINESS EXPERIENCE
Name of company - City *
Title - Percentage of ownership *
Dates in service or Dates in operation (From/to) *
Description of duties - Sector of Business - Number of total employees *
Name of company 2 - City
Title and Percentage of ownership
Dates in service or Dates in operation (From/To)
Description of duties - Sector of Business - Number of total employees
Name of Company 3 - City
Title and Percentage of ownership
Dates in Service or Dates in operation (FROM/TO)
Description of duties - Sector of business - Number of total employees
LANGUAGES
Knowledge of English * Fluent Moderate Basic Not at all
Knowledge of French * Fluent Moderate Basic Not at all
SPOUSE INFORMATION
Name First Last
Date of birth / DD / MM YYYY
SECONDARY AND POST SECONDARY EDUCATION (SPOUSE) 1st Diploma or Degree Name of Diploma or Degree completed
Dates of study From/To
Name of educational institution, City and Country
2nd Diploma or Degree (Spouse) Name of Diploma or Degree
Dates of study (From/To)
Name of edcational institution, City and Country
WORK EXPERIENCE - SPOUSE
Name of Company
Title
Dates in service (From/To)
Description of duties
Name of Company 2
Title
Dates in service From/To
Description of duties
LANGUAGES (SPOUSE)
ENGLISH Fluent Moderate Basic Not at all
FRENCH Fluent Moderate Basic Not at all
NUMBER OF CHILDREN WITH AGES
Have you ever travelled to Canada in the past? If so, when and how long? Under what type of visa?
Amount of settlement funds upon arriving in Canada?
Total Net worth *

The net worth is the value of your assets and your wife's assets minus total liabilities or debts. They may include the value of commercial or residential property, investments, shares, donations, etc. The total net worth will determine the business category under which you may apply.
RELATIVES IN CANADA Level of relationship (Brother,sister, aunt, uncle, niece, nephew) In which Province do they reside?
Preferred Province of destination
Referred by whom or by which organization?
You may upload a document or a resume

Evaluation form - Business Applicant

Evaluation form - Business Applicant

MANAGEMENT EXPERIENCE or BUSINESS EXPERIENCE

LANGUAGES

SPOUSE INFORMATION

WORK EXPERIENCE - SPOUSE

LANGUAGES (SPOUSE)