ASSESSMENT FORM Assessment form Welcome to Coxswain Global Education Assessment Form for Canada First NameLast NameEmail AddressPhoneAge-Select Age-17 Years or less18 Years19 Years20 Years21 Years22 Years23 Years24 Years25 Years26 Years27 Years28 Years29 Years30 Years31 Years32 Years33 Years34 Years35 Years36 Years37 Years38 Years39 Years40 Years41 Years42 Years43 Years44 Years45 Years or moreDate of birthmm/dd/YYNationality-Select-NoneÅland IslandsAfghanistanAkrotiriAlbaniaAlgeriaAmerican SamoaAngolaAndorraAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAshmore and Cartier IslandsAustriaAustraliaAzerbaijanBahrainBangladeshBarbadosBassas Da IndiaBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurmaBurundiCambodiaCameroonCanadaCape VerdeCaribbean NetherlandsCayman IslandsCentral African RepublicChadChileChinaChristmas IslandClipperton IslandCocos (Keeling) IslandsColombiaComorosCook IslandsCoral Sea IslandsCosta RicaCote D'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDemocratic Republic of the CongoDenmarkDhekeliaDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaEuropa IslandFalkland Islands (Islas Malvinas)Faroe IslandsFederated States of MicronesiaFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern and Antarctic LandsGabonGaza StripGeorgiaGermanyGhanaGibraltarGlorioso IslandsGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-bissauGuyanaHaitiHeard Island and Mcdonald IslandsHoly See (Vatican City)HondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJan MayenJapanJerseyJordanJuan De Nova IslandKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNavassa IslandNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParacel IslandsParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRepublic of the CongoReunionRomaniaRussiaRwandaSaint BarthSaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouth SudanSpainSpratly IslandsSri LankaSudanSurinameSvalbardSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandThe BahamasThe GambiaTimor-lesteTogoTokelauTongaTrinidad and TobagoTromelin IslandTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin IslandsWake IslandWallis and FutunaWest BankWestern SaharaYemenZambiaZimbabweMarital StatusSelect Marital StatusSingleMarriedWidowedLegally SeparatedDivorcedCurrent Country of ResidenceChoose itNoneÅland IslandsAfghanistanAkrotiriAlbaniaAlgeriaAmerican SamoaAngolaAndorraAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAshmore and Cartier IslandsAustriaAustraliaAzerbaijanBahrainBangladeshBarbadosBassas Da IndiaBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurmaBurundiCambodiaCameroonCanadaCape VerdeCaribbean NetherlandsCayman IslandsCentral African RepublicChadChileChinaChristmas IslandClipperton IslandCocos (Keeling) IslandsColombiaComorosCook IslandsCoral Sea IslandsCosta RicaCote D'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDemocratic Republic of the CongoDenmarkDhekeliaDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaEuropa IslandFalkland Islands (Islas Malvinas)Faroe IslandsFederated States of MicronesiaFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern and Antarctic LandsGabonGaza StripGeorgiaGermanyGhanaGibraltarGlorioso IslandsGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-bissauGuyanaHaitiHeard Island and Mcdonald IslandsHoly See (Vatican City)HondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJan MayenJapanJerseyJordanJuan De Nova IslandKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNavassa IslandNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParacel IslandsParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRepublic of the CongoReunionRomaniaRussiaRwandaSaint BarthSaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouth SudanSpainSpratly IslandsSri LankaSudanSurinameSvalbardSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandThe BahamasThe GambiaTimor-lesteTogoTokelauTongaTrinidad and TobagoTromelin IslandTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin IslandsWake IslandWallis and FutunaWest BankWestern SaharaYemenZambiaZimbabweStreet AddressCityState/ProvinceZIP / Postal CodeAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaAustraliaArubaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCabo VerdeCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGuernseyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSaint HelenaSaint Pierre & MiquelonSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUS Minor Outlying IslandsUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemen Arab Rep.Yemen DemocraticZambiaZimbabweCountryAre you a Resident of Canada?YesNoWhat's your current status in Canada? *VisitorStudentWork PermitPGWP HolderWorker - Open Work PermitWorker - Closed Work PermitPR / Canadian CitizenRefugeeImplied StatusOut of StatusOtherStart date of your Permit or Status in Canada?Do you have a valid Canadian Visa? *YesNoVisa/Permit or Status Validity?Do you or your spouse have Relatives living in Canada?-Select-NoneBlood relative e.g. child, parent, siblings etc.Province where the Relatives live-Select-SelectAlberta (AB)British Columbia (BC)Manitoba (MB)New Brunswick (NB)Newfoundland and Labrador (NL)Northwest Territories (NT)Nova Scotia (NS)Nunavut (NU)Ontario (ON)Prince Edward Island (PE)Quebec (QC)Saskatchewan (SK)Yukon (IT)Area of InterestImmigrate to CanadaFamily SponsorshipWork Permits for CanadaStudy in CanadaBusiness ImmigrationVisit CanadaVisa for other Countries except CanadaNothingDo you want to provide your Work Experience & Education details?YesNo, I have a different requirementEDUCATION:What is your highest level of education?SelectDoctoral Level university Degree (Ph. D.)Master's Degree or Professional Degree needed to practice in a Licensed ProfessionTwo or more certificates, Diplomas or Degree, One must be for a program of three or more yearsBachelor's Degree (three or more year program at a University, College, Trade or Technical School or other Institute)Two year program at a University, College, Trade or Technical School or other InstituteOne year program at a University, College, Trade or Technical School or other InstituteSecondary Diploma (High School Graduation)None or less than secondary (High School)Field of Study:Have you done Educational Credential Assessment (ECA) for your existing international education?YesNoIf yes, what is the Level of education as mentioned on your ECA report?CANADIAN EDUCATION:Have you studied in Canada?-Select-SelectYesNoLevel of education?-Select-SelectMaster's Degree or PhDBachelor Degree or Diploma of 3 years or longer2-years Diploma or Certificate1-year Diploma or CertificateSecondary (High School) or lessCourse NameCollege NameProvince of Education-Select-SelectAlberta (AB)British Columbia (BC)Manitoba (MB)New Brunswick (NB)Newfoundland and Labrador (NL)Northwest Territories (NT)Nova Scotia (NS)Nunavut (NU)Ontario (ON)Prince Edward Island (PE)Quebec (QC)Saskatchewan (SK)Yukon (IT)Course Duration-Select-1 Year2 Year3 Year4 Year5 YearCourse Intake Start (e.g. Jan, 2019)Course Completion (e.g. Jan, 2019)Have You studied more than one course in Canada?-Select-YesNoLevel of education?-Select-SelectMaster's Degree or PhDBachelor Degree or Diploma of 3 years or longer2-years Diploma or Certificate1-year Diploma or CertificateSecondary (High School) or lessCourse NameCollege NameProvince of Education-Select-SelectAlberta (AB)British Columbia (BC)Manitoba (MB)New Brunswick (NB)Newfoundland and Labrador (NL)Northwest Territories (NT)Nova Scotia (NS)Nunavut (NU)Ontario (ON)Prince Edward Island (PE)Quebec (QC)Saskatchewan (SK)Yukon (IT)Course Duration-Select-Select1 Year2 Year3 Year4 Year5 YearLANGUAGE:Have you taken an English Language Test?-Select--Select-CELPIPIELTSNoneType of Test takenSelectGeneralAcademicCELPIP - Test ScoreSpeaking-Select-10-12987654M,0-3Listening-Select-10-12987654M,0-3Reading-Select-10-12987654M,0-3Writing-Select-10-12987654M,0-3IELTS- Test ScoreSpeaking-Select-7.5-9.07.06.56.05.55.04.0-4.50-3.5Reading-Select-8.0-9.07.0-7.56.565.0-5.54.0-4.53.50-3.0Writing-Select-7.5-9.07.06.56.05.55.04.0-4.50-3.5Listening-Select-8.5-9.087.56.5-7.06.05.554.50-4.0Do you know French?-Select--Select-YesNoHave you taken a French Language Test? (TEF or TCF) *-Select--Select-TEFTCFNoneTEF - Test ScoreSpeaking-Select-393-450371-392349-370310-348271-309226-270181-2250-180Listening-Select-316-360298-315280-297249-279217-248181-216145-1800-144Reading-Select-263-300248-262233-247207-232181-206151-180121-1500-120Writing-Select-393-450371-392349-370310-348271-309226-270181-2250-180TCF - Test ScoreSpeaking-Select-393-450371-392349-370310-348271-309226-270181-2250-180Listening-Select-316-360298-315280-297249-279217-248181-216145-1800-144Reading-Select-263-300248-262233-247207-232181-206151-180121-1500-120Writing-Select-393-450371-392349-370310-348271-309226-270181-2250-180INTERNATIONAL WORK EXPERIENCELast 10 years OnlyType of Work Experience-Select-Highly Skilled PositionSemi-Skilled (Truck Driver, Healthcare etc.)Agricultural, Laborer etc.Trade Jobs(Chef, Plumber, Electrician etc.)HomemakerFresher - No Work ExperienceOccupation / DesignationYears of Experience-Select-6 Years or more5 Years or more, but less than 6 years4 Years or more, but less than 5 years3 Years or more, but less than 4 years2 Years or more, but less than 3 years1 Year or more, but less than 2 yearsLess than 1 YearDo you want to provide additional Work Experience?-Select-YesNoType of Work Experience-Select-Highly Skilled PositionSemi-Skilled (Truck Driver, Healthcare etc.)Agricultural, Laborer etc.Trade Jobs(Chef, Plumber, Electrician etc.)HomemakerFresher - No Work ExperienceOccupation / DesignationYears of Experience-Select-6 Years or more5 Years or more, but less than 6 years4 Years or more, but less than 5 years3 Years or more, but less than 4 years2 Years or more, but less than 3 years1 Year or more, but less than 2 yearsLess than 1 YearCANADIAN WORK EXPERIENCE:Type of Work Experience-Select-Highly Skilled PositionSemi-Skilled (Truck Driver, Healthcare etc.)Agricultural, Laborer etc.Trade Jobs(Chef, Plumber, Electrician etc.)HomemakerFresher - No Work ExperienceOccupation / DesignationYears of Experience-Select-6 Years or more5 Years or more, but less than 6 years4 Years or more, but less than 5 years3 Years or more, but less than 4 years2 Years or more, but less than 3 years1 Year or more, but less than 2 yearsLess than 1 YearIs this your current job?YesNoProvince-Select-Alberta (AB)British Columbia (BC)Manitoba (MB)New Brunswick (NB)Newfoundland and Labrador (NL)Northwest Territories (NT)Nova Scotia (NS)Nunavut (NU)Ontario (ON)Prince Edward Island (PE)Quebec (QC)Saskatchewan (SK)Yukon (IT)Additional Canadian Experience details?YesNoType of Work Experience-Select-Highly Skilled PositionSemi-Skilled (Truck Driver, Healthcare etc.)Agricultural, Laborer etc.Trade Jobs(Chef, Plumber, Electrician etc.)HomemakerFresher - No Work ExperienceYears of Experience-Select-6 Years or more5 Years or more, but less than 6 years4 Years or more, but less than 5 years3 Years or more, but less than 4 years2 Years or more, but less than 3 years1 Year or more, but less than 2 yearsLess than 1 YearOccupationProvince-Select-Alberta (AB)British Columbia (BC)Manitoba (MB)New Brunswick (NB)Newfoundland and Labrador (NL)Northwest Territories (NT)Nova Scotia (NS)Nunavut (NU)Ontario (ON)Prince Edward Island (PE)Quebec (QC)Saskatchewan (SK)Yukon (IT)Do you have a valid Job Offer from an Employer in Canada?YesNoProvince where the Employer is located-Select-Alberta (AB)British Columbia (BC)Manitoba (MB)New Brunswick (NB)Newfoundland and Labrador (NL)Northwest Territories (NT)Nova Scotia (NS)Nunavut (NU)Ontario (ON)Prince Edward Island (PE)Quebec (QC)Saskatchewan (SK)Yukon (IT)Is the Employer ready to give you a valid Job offer?YesNoIs the Employer willing to support you for PNP?YesNoUpload your ResumeChoose FileNo file chosenDelete uploaded fileDo you have accompanying dependents in this application?-Select-Only MyselfAccompanying Spouse or Common-law partnerOther accompanying dependentsProvide basic information about your accompanying spouse or common-law partner.YesNoWhat is the age of your spouse or common-law partner?-Select-17 Years or less18 Years19 Years20 Years21 Years22 Years23 Years24 Years25 Years26 Years27 Years28 Years29 Years30 Years31 Years32 Years33 Years34 Years35 Years36 Years37 Years38 Years39 Years40 Years41 Years42 Years43 Years44 Years45 Years or moreWhat is the highest level of education of your spouse or common-law partner?-Select--Select-Doctoral Level university Degree (Ph. D.)Master's Degree or Professional Degree needed to practice in a Licensed ProfessionTwo or more certificates, Diplomas or Degree, One must be for a program of three or more yearsBachelor's Degree (three or more year program at a University, College, Trade or Technical School or other Institute)Two year program at a University, College, Trade or Technical School or other InstituteOne year program at a University, College, Trade or Technical School or other InstituteSecondary Diploma (High School Graduation)None or less than secondary (High School)How many years of Canadian work experience does your spouse/common-law partner have?-Select--Select-6 Years or more5 Years or more, but less than 6 years4 Years or more, but less than 5 years3 Years or more, but less than 4 years2 Years or more, but less than 3 years1 Year or more, but less than 2 years9 Months or more, but less than 1 year6 Months or more, but less than 9 months3 Months or more, but less than 6 monthsLess than 3 monthsNot ApplicableDid your spouse or common-law partner take a language test? If so, which one?-Select-IELTSCELPIPTEFTCFNoneType of Test takenGeneralAcademicIELTS - Test ScoreSpeaking-Select-7.5-9.076.565.554.0-4.50-3.5Listening-Select-8.5-9.087.56.5-7.06.05.554.50-4.0Reading-Select-8.0-9.07.0-7.56.565.0-5.54.0-4.53.50-3.0Writing-Select-7.5-9.07.06.56.05.55.04.0-4.50-3.5CELPIP - Test ScoreSpeaking-Select-10-12987654M, 0-3Listening-Select-10-12987654M, 0-3Reading-Select-10-12987654M, 0-3Writing-Select-10-12987654M, 0-3TEF - Test ScoreSpeaking-Select-393-450371-392349-370310-348271-309226-270181-2250-180Listening-Select-316-360298-315280-297249-279217-240181-216145-1800-144Reading-Select-293-300248-262207-232181-206151-180121-1500-120Writing-Select-393-450371-392349-370310-348271-309121-150226-270181-2250-180TCF - Test ScoreSpeaking-Select-16-2014-1512-1310-117-964-50-3Listening-Select-549-699523-548503-522458-502398-457469-397331-3680-330Reading-Select-549-699524-548499-523453-498406-452375-405342-3740-341Writing-Select-16-2014-1512-1310-117-964-50-3Please provide additional case details:Have you or your dependents ever been Refused a Visa or Denied entry from any country in the Past?YesNoPlease provide more details about your refusalDo you want to provide additional documents?Choose FileNo file chosenDelete uploaded fileI Agree to the Privacy Policies, Disclaimers, Terms & conditions.I'm not a robot Send Message