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Assessment for Quebec Skilled Workers

For applicants qualifying on the basis of their educational background and professional expertise.
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1) General Information
2) Key Factors
If your occupation is not listed, Please provide details:
Have you ever stayed in Province of Quebec for more than two weeks? If so, please explain the detail. (Period, purpose of stay)
Do you or your partner have a relative who is a Canadian citizen, or a permanent resident living in Canada? If you do, in which province does the relative currently live?
Do you, your partner or children have any serious physical or mental problems? If so, please explain the detail.
Have you, your partner or children ever been convicted or are currently charged with any crime or offense in any country? If so, please explain the detail.
Have you, your partner or children ever been refused permanent or temporary resident status (visitor visa, study permit, work permit) of Canada ? If so, please explain the detail.
Have you, your partner or children ever been refused admission to Canada, or ordered to leave Canada? If so, please explain the detail.
3) Official Languages

Please indicate your abilities in both the English and French languages, as follows:

FLUENT:
Very good command of the language in a range of social and work situations, and no difficulty communicating in a professional capacity.
WELL:
Can communicate reasonably well about personal and familiar things.
WITH DIFFICULTY:
Command of just a few basic words.
4) Applicant's Spouse
Children Ages
Occupation
If your spouse's occupation is not listed, Please provide details.
English language skill
FLUENT:
Very good command of the language in a range of social and work situations, and no difficulty communicating in a professional capacity.
WELL:
Can communicate reasonably well about personal and familiar things.
WITH DIFFICULTY:
Command of just a few basic words.
English
6) Additional information
Use this text field for additional information.