Preliminary Assessment Form

Preliminary Assessment Form

This form must be completed before an initial assessment interview is arranged between the Client and Immigration Consultant

Personal Information:

English Language Test

If you have taken an IELTS or CELPIP English language test, please complete the following:


Provide the following information for your high school and ALL schools attended thereafter, whether completed or not. (Add lines, as necessary.)

School 1

School 2

School 3

Employment History

Please provide your employment history for the past ten (10) years—beginning with current—and include part-time positions. (Add lines, as necessary.)

Job 1

Job 2

Job 3


Please list all international travel in the last ten (10) years.

Travel 1

Travel 2

Travel 3

Additional Questions

Read the following carefully and answer truthfully. Have you or your spouse/partner or dependents ever:

Is there any other information that you feel is important to share as part of your preliminary assessment?