Federal Skilled Worker Evaluation Please fill the given below form, so that we can evaluate your application for Federal Skilled Worker ADMINISTRATIVE INFORMATION Your Email (required) Your Full Name (required) Your Age (required) Gender Marital Status(required) Male Female ---Never MarriedMarriedWidowedLegally SeparatedAnulled MarriageDivorcedCommon-Law Phone Number (required) Address Nationality ---AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia, Plurinational State ofBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo, the Democratic Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIran, Islamic Republic ofIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedonia, the former Yugoslav Republic ofMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia, Federated States ofMoldova, Republic ofMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian Territory, OccupiedPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian FederationRwandaSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwan, Province of ChinaTajikistanTanzania, United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVenezuela, Bolivarian Republic ofViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Residence HIGHEST EDUCATION Highest Education Completion Status ---CompletedNot Completed Program / Specialty LANGUAGE SKILLS English Proficiency Reading ---High ProficiencyModerate ProficiencyBasic ProficiencyNo Proficiency Writing ---High ProficiencyModerate ProficiencyBasic ProficiencyNo Proficiency Speaking ---High ProficiencyModerate ProficiencyBasic ProficiencyNo Proficiency Listening ---High ProficiencyModerate ProficiencyBasic ProficiencyNo Proficiency French Proficiency Reading ---High ProficiencyModerate ProficiencyBasic ProficiencyNo Proficiency Writing ---High ProficiencyModerate ProficiencyBasic ProficiencyNo Proficiency Speaking ---High ProficiencyModerate ProficiencyBasic ProficiencyNo Proficiency Listening ---High ProficiencyModerate ProficiencyBasic ProficiencyNo Proficiency WORK EXPERIENCE A. Select occupations from list where you have at least 1 year of experience ( if none go to B) ---Accommodation Service ManagersAudiologists & Speech Language PathologistsChefsCollege & Other Vocational InstructorsComputer & Information System ManagersConstruction ManagersContractors & Supervisors, Carpentry tradesContractors & Supervisors, Heavy Construction EquipmentContractors & Supervisors, Pipe Fitting TradesCooksCrane OperatorsDrillers & Blasters - Surface Mining, Quarrying & constructionElectrician (except Industrial & Power System)Financial Auditors & AccountantsFinancial ManagersGeneral Practitioners & Family PhysiciansGeological EngineersGeologists, Geo-chemists & GeophysicistsHead Nurse & SupervisorsHeavy Duty Equipment MechanicsIndustrial ElectriciansLicensed Practical NurseManagers in Health CareMedical Radiation TechnologistsMining EngineersOccupational TherapistsPetroleum EngineersPhysiotherapistsPlumbersRegistered NursesRestaurants & Food Service ManagersSpecialist PhysiciansSteamfitters, Pipe fitters & Sprinkler System InstallersSupervisors, Mining and QuarryingSupervisors, Oil & Gas Drilling ServiceSupervisors, Petroleum, Gas & Chemical Processing & UtilitiesUniversity ProfessorsWelders & Related Machine Operators Year(s) of Experience ---1-11 Months Experience1 Year of Experience2 Years of Experience3 Years of Experience4 Years or more Experience B. Indicate other Occupation ---Accommodation Service ManagersAudiologists & Speech Language PathologistsChefsCollege & Other Vocational InstructorsComputer & Information System ManagersConstruction ManagersContractors & Supervisors, Carpentry tradesContractors & Supervisors, Heavy Construction EquipmentsContractors & Supervisors, Pipe Fitting TradesCooksCrane OperatorsDrillers & Blasters - Surface Mining, Quarrying & constructionElectrician (except Industrial & Power System)Financial Auditors & AccountantsFinancial ManagersGeneral Practitioners & Family PhysiciansGeological EngineersGeologists, Geo-chemists & GeophysicistsHead Nurse & SupervisorsHeavy Duty Equipments MechanicsIndustrial ElectriciansLicensed Practical NurseManagers in Health CareMedical Radiation TechnologistsMining EngineersOccupational TherapistsPetroleum EngineersPhysiotherapistsPlumbersRegistered NursesRestaurants & Food Service ManagersSpecialst PhysiciansSteamfitters, Pipe fitters & Spinkler System InstallersSupervisors, Mining and QuarryingSupervisors, Oil & Gas Drilling ServiceSupervisors, Petroleum, Gas & Chemical Processing & UtilitiesUniversity ProfessorsWelders & Related Machine Operators Year(s) of Experience ---1-11 Months Experience1 Year of Experience2 Years of Experience3 Years of Experience4 Years or more Experience ADDITIONAL INFORMATION Do you have a job offer in Canada? ---Have arranged employment in CanadaNo arranged employment in Canada Have you or your spouse / common-law partner worked in Canada? * ---Worked Full time in Canada for at least one yearNo, or has worked Full time in Canada for less than one year Have you or your spouse / common-law partner studied in Canada? * ---Completed at least 2 years of post-secondary education in CanadaNo, or has less than 2 years of post-secondary education in Canada Do you have relatives in Canada? ---NoBrotherSisterUncleAuntNephewNieceParentChildGrandparent How many children do you have? ---012345678