ASSESSMENT FORM – FOR STUDY IN CANADA

• Personal Profile
Full Name _______________________ Contact Number __________________________
Email _____________________________ Whatsapp _____________________________.
Address
____________________________________________________________________________________
Date of Birth: ________________________ Age: ______ Years
Nationality: __________________ Country of Current Residence: _________________
Select your marital status: Single / Married / Common Law Partner
Do you have any children under 19 years of age (if)? How many and ages ________________________

• Language Proficiency
Have you taken language proficiency test (IELTS) in the last two years? Yes /No
If Yes, Overall Score: ……….. L ……… R ………. W………. S ………
If No, When you have plans to take: Have you taken GRE/GMAT? Yes / No

• Education & Training

What is your highest level of education? ___________________ Year of Passing: ________
Major Subject(s): _________________________ Aggregate GPA/Grades __________________
Do you have any gap between your studies? _____ For how many years: _______________ Do
you have any full-time / part-time work experience?
____________________________________________________________________________________

In which session you are interested: Fall/Sep Winter/Jan Spring/May In which subject
you are interested: 1) _______________ 2) _______________

• Family/Friends/Relatives in Canada
Does any of your family members/relatives (18 years or older) live in Canada? Yes / No
Which Province and City: Province __________________ City __________________

• Finances Available
Amount: __________________ Can you manage 4 months old bank statement: __________________

Documents Required (in pdf format and individually): Recent Pic, Copy of passport, IELTS &
academic documents (Transcript & Degrees) and complete address with phone and email.
-------------------------------------------------------------------------------------------------------------------------
For Office Use:

Qualified: Yes/No What needs to be Ready?

Potential Institution in Canada: Session: SDS/Regular

1708 – 2440 Hurontario St Cell/Whatsapp: +1 (289) 990-7580
Mississauga, ON L5B1N2 Email: szaidi45@gmail.com
Canada Facebook: @primeeducation1
@canadianimmigration1
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