Canadian Business Immigrant Entrepreneur FREE Assessment

The Canada Immigration Consulting Agency Co. (CICA) Online FREE Assessment Forms are tools that assists us in determining your eligibility to successfully immigrate to Canada temporarily or permanently. The Online FREE Assessment Forms are completely free and confidential. Upon receipt of your Online FREE Assessment Form, we shall review your application and we will contact you to discuss the results. Please note that a positive assessment does not guarantee the issuance of a visa. Only Citizenship and Immigration Canada can grant permanent or temporary resident status to foreign nationals.

Principal Applicant - Personal Information
Please ensure to complete the assessment below pertaining to your personal information. It is very important to provide us with a valid contact number and advise us of any changes in your personal information and contact numbers. * Indicates field required

Surname/Family Name:*
First Name:*
Sex:*
Date of Birth:*
City/Town of Birth:*
Country of Birth:*
Citizenship:*
Marital Status:*
Number of Children:
Ages of Children:
Home Telephone: (include area code)*
Work Telephone: (include area code)
Fax Number: (include area code)
Cellular/Mobile Number: (include area code)
Email: (please ensure your email is active)* if you don't have have an E-mail address, click here
Other Contact Number: (include area code)
Current Address* Street Name and Number:*
City/Town:*
Province/State:
Postal/Zip Code:
Country:*
How long have you legally resided in this country?*
List other countries that you have legally resided for at least 1 year in the past.

Principal Applicant - Education
Please enter the boxes correctly indicating the number of years completed at each level of education (e.g primary school - 6 years, apprenticeship - 2 years). It is very important to correctly account the number of years completed at each level to better assess your application. * Indicates field required

Highest Level of Education:*
Highest Qualification Designation:* e.g. BS in Engineering

Education	Diploma Attained	Indicate the number of years completed in this level of education
PhD:
Master Degree:
2nd Bachelor Degree:
1st Bachelor Degree:
Apprenticeship:
Secondary/High School:
Primary/Elementary School:

Principal Applicant - Language Ability
Language ability is one component that is essential in the application. Please ensure that you correctly complete the fields below. * Indicates field required
Indicate your first official language*:
If your language ability is in both English and French, decide which of the two will be your first official language
Language	Speaking	Reading	Writing	Listening
English*
French*
Have you taken the following language examination?: If yes, indicate your test results.		IELTS	CELPIP	TEF
	Speaking	Reading	Writing	Listening

Principal Applicant - Business Experience
Please indicate below your Business experience. Business experience must have been obtained within the period beginning five years before the date of application.
	Title/Position	Type of Business	Years of Experience	Job Description
1
2
3
4
Business Activities Please provide additional/relevant information that can assist and support your application for permanent residence under the Business Class - Investor. Also, please indicate the type of business activity that you would like to engage upon arriving in Canada.

Please complete this section only if you have owned a business in the last five years.
Please indicate your percentage of ownership in the business that you owned. (If you owned more than one business, please choose the business that you own that has your highest percentage of ownership)
Please indicate the number of employees employed full-time.
Please indicate if your business had gross sales of more than $500,000 CDN per year in at least two of the last five years.
Please indicate if your business had a net income of more than $50,000 CDN per year in at least two of the last five years.
Please indicate if your business had net equity of more than $125,000 CDN per year in at least two of the last five years.
Please indicate if your net worth, inclusive of the assets of your spouse/common-law partner/same-sex partner, if applicable.
Is less than 300,000 Canadian Dollars?
Is equal to or greater than 300,000 Canadian Dollars but less than 800,000 Canadian Dollars?
Is equal to or greater than 800,000 Canadian Dollars?
Please confirm that your net worth was obtained legally or through your own endeavors (ie. inheritance, gift, etc.)

Financial Information
Please indicate below your and your spouse's, if applicable, personal net worth in CAD Dollars. 1. List all your liquid assets and their current value (e.g. cash, bonds, savings, stocks). 2. List all your fixed assets at their current value (e.g. house, car, land). 3. Pension and mutual Funds and their current value. 4. Business (specify your % of ownership and its current value). 5. List your liabilities and personal debt and the current value. 6. Add all your liabilities and personal debt and subtract the sum of your total liabilities and personal debt to the sum of all your assets (add the value of 1+2+3+4). * Indicates field required

Total Net Worth:*	CAD $
Indicate the total value of funds already in Canada, if applicable:	CAD $

Spouse/Common-Law Partner (if applicable) - Personal Information
If you have a spouse or a common-law partner or same sex partner, please complete the questionnaire below. If you are SINGLE/NEVER MARRIED, please proceed to Adaptability.
Surname/Family Name:*
First Name:*
Sex:*
Date of Birth:*
City/Town of Birth:*
Country of Birth:*
Citizenship:*
Home Telephone: (include area code)*
Work Telephone: (include area code)
Fax Number: (include area code)
Cellular/Mobile Number: (include area code)
Email: (please ensure your email is active)*
Other Contact Number: (include area code)
Dependent Children (please provide their names and ages, if applicable)

Spouse/Common - Law Partner Education
Highest Level of Education:*
Highest Qualification Designation:* e.g. BS in Engineering
Education	Diploma Attained	Indicate the number of years completed in this level of education
PhD:
Master Degree:
2nd Bachelor Degree:
1st Bachelor Degree:
Apprenticeship:
Secondary/High School:
Primary/Elementary School:

Spouse/Common-Law Partner - Language Ability
Language ability is one component that is essential in the application. Please ensure that you correctly complete the fields below. * Indicates field required
Indicate your first official language*:
If your language ability is in both English and French, decide which of the two will be your first official language
Language	Speaking	Reading	Writing	Listening
English*
French*
Have you taken the following language examination?: If yes, indicate your test results.		IELTS	CELPIP	TEF
	Speaking	Reading	Writing	Listening

Spouse/Common-Law Partner - Work Experience
Please indicate below your work experience. Work experience MUST be PAID FULL TIME employment within the last 10 years. Full time employment is considered as 37.5 hours per week. NOTE: Work experience obtained prior to 10 years ago will not be credited.
	Occupation	Years of Experience	Job Description
1
2
3
4
5

Adaptability
You have made a business exploration trip to Canada in the period beginning five years before the date of your application.
You have participated in joint federal-provincial business immigration initiatives.

Admissibility
Do you or your spouse and/or any of your dependants, if applicable ever:
Been detained or in jail?
Been convicted of or are currently charged with any crime or offence in any country?
Applied previously for any temporary resident visa to Canada (visitor, work, study)?
Been refused a Canadian visa?
Had any serious disease or physical mental disorder?
Been involved in an act of genocide, war crimes, commission of crime against humanity?
Been refused admission to, or ordered to leave Canada or any other country?
Previously sought Refugee status or applied for permanent resident visa to Canada?
Been a member of an organization that is engaged in criminal activities?
Been associated with a group that advocates or implements violence to reach political, religious or social objectives?
If you have answered "yes" to any of the questions the above, please provide details below:

Additional Information
How did you learn about our website?
How did you learn about our services?
Other - specify:
Please indicate the reason you have contacted Canada Immigration Consulting Agency Co. (CICA).
Please indicate how Canada Immigration Consulting Agency Co. (CICA) can assist you.