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Name:
E-mail:
Age:
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1
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100
Marital status:
Select
Single
Married
Divorced
Seperated
Widowed
Total Years of Education:
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0
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30+
How many years of pre-college education starting with grade 1?:
Select
0
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15
How many years of college?:
Select
0
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2
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5
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10
11
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14
15
College diploma obtained:
How many years of University education?:
Select
0
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4
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10
11
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14
15
What was your major at University?:
Other educational programs or courses:
How many years of work experience?:
Select
0
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70
List field(s) of work in the last ten years:
Knowledge of languages:
English?
Select
Very fluent
Fluent
Functional
Little
None
French?
Select
Very fluent
Fluent
Functional
Little
None
Wife or Husband's education (years in total):
Select
0
1
2
3
4
5
6
7
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70
Secondary school:
Select
0
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8
College:
Select
0
1
2
3
4
5
6
7
8
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14
15
University:
Select
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Wife's / husband's years of experience:
Select
0
1
2
3
4
5
6
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11
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63
64
65
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69
70
List wife's / husband's field of work in the last ten years:
Wife's / husband's knowledge of languages:
English?
Select
Very fluent
Fluent
Functional
Little
None
French?
Select
Very fluent
Fluent
Functional
Little
None
Amount saved up to resettle to Canada:
Select
0 - 5000$
5000$ - 10000$
10000$ - 20000$
over 20000$
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