Dear Sir/Madam:

Please complete the assessment form and click the "Submit" button at the bottom of the page when finished. If you are married or engaged, you will be directed to complete an assessment form for your spouse or fiancée. If you are a business owner, you will be directed to complete a business form. 

We will review your information and contact you with the results of our assessment.
Thank you.


Worldwide Relocation Services Inc.

Student Assessment Form * = Required fields     
 Personal Information
* Full Name (First Middle Last)  
* Date of Birth  (Year)

Place of Birth

  
  Citizenship

* Email Address

  
* Marital Status Number of Children: (if applicable)  
* Contact Phone

Home Fax

  
   Work Phone

Work Fax

  
* Current Mailing Address:  
 
 Parent/Guardian Information
  Name Phone
  Address
 
 Program Interested in
  Program Interested in  Description
 
 Financial Information
  I have financial means to support my studies in Canada.  Funds available are:   
  Please fill in the amount available from each source.
     Self

Relatives

     Parents

Others

 
 Relatives Information
Details of your relatives in Canada who can be of support you. 
(Describe the relationship clearly, such as father's real brother, mother's real sister, etc.)
Name Relationship Address

 
 Education Information
* Please provide your educational record with dates, name and address of institutions attended, courses taken, and degree/diploma/certificate received.  Include all full time and part time courses.

Period

Name & Address of Institution

Courses

Diploma/Degree/Certificate
Month   Year       Month   Year
From:/  To:/

From:/  To:/

From:/  To:/

 
 Employment Information
* Please provide your employment record(s) with dates, name & address of employers, job titles and duties performed. 
If you are applying for career opportunities, pleas attach a resume which includes detailed description of your job duties.
Period Name & Address of Employers Job Title & Job Duties
 Month    Year      Month    Year
From:/   To:/

From:/   To:/

From:/   To:/

 
 Resume
 Attach (copy & paste) your resume below:
 
 
 Language Skills
  
Please indicate your ability to communicate in English and French.
   English French
High Moderate Basic None High Moderate Basic None
 Speaking
 Reading
 Writing
 Listening
Scores Reading Speaking Writing Listening
 TOEFL
 IELTS
 TEF
GRE & GMT
 
Your current status in the country where applying?
Have you or any other family member ever applied for or refused Canadian Immigration?
If yes, please give details:
Have you ever been refused tourist or other visas?
If yes, please give details:
How did you come to know about WRSI?  
 

By clicking "Submit" I declare that the information given in this application is truthful, complete and correct.