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Express Entry Assessment
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First name
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Last name
*
Date of birth
*
MM slash DD slash YYYY
Marital status
*
Single
Married
Common-law
Divorced
Widowed
Email
*
Phone number (WhatsApp)
*
Country of birth
*
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cabo Verde
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Canada
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Mali
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Marshall Islands
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Mexico
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Monaco
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Morocco
Mozambique
Myanmar
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Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
North Korea
North Macedonia
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Other
Preferred points-based pathway
*
Federal Skilled Worker (FSW)
Quebec Skilled Worker
Provincial Nominee Program (PNP)
Highest education (Canadian equivalency)
*
Doctorate / PhD
Master's / professional degree (medicine, law, etc.)
Two or more credentials (one 3+ years)
3-year or longer credential
2-year credential
1-year credential
High school diploma
Field of study
*
Do you have an ECA (Educational Credential Assessment)?
*
Yes
No
Have you taken a recognized language test?
*
Yes
No
Language test type
*
IELTS
CELPIP
TEF
TCF
PTE
Listening score
*
Reading score
*
Speaking score
*
Writing score
*
Do you have a strong second official language?
*
Yes
No
Second-language test type
*
Example: IELTS / CELPIP / TEF / TCF
Listening score (second language)
*
Reading score (second language)
*
Speaking score (second language)
*
Writing score (second language)
*
Skilled work experience
*
Less than 1 year
1 year
2 – 3 years
4 – 5 years
More than 6 years
Occupation category
*
Healthcare
STEM
Trades
Transportation
Agriculture & agri-food
Other
Job duties and responsibilities
*
Canadian work experience
*
None
Less than 1 year
1 year
2 years
3 years or more
Do you have a valid Canadian job offer?
*
Yes
No
Do you have a close relative in Canada?
*
Yes
No
Target province/city (for PNP or job offer)
*
Toronto
Montreal
Vancouver
Calgary
Edmonton
Ottawa
Winnipeg
Quebec City
Halifax
Other / not decided yet
Settlement funds
*
Less than CAD 13,757
CAD 13,757 – 17,127
CAD 17,127 – 21,055
CAD 21,055 – 25,564
CAD 25,564 – 29,846
CAD 29,846 – 34,023
More than CAD 34,023
Does your spouse have English/French language skills?
*
Yes
No
Will your spouse accompany you?
*
Yes
No
Have you had a visa refusal?
*
Yes
No
Refusal countries
*
Additional notes (optional)