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Applicant - Personal Details

Our free eligibility assessment form for Independent / Skilled Workers consists of 4 steps and takes approximately 10 minutes to complete. Please fill in the questionnaire below to begin.

Family or Surname First Name Title Gender - Mr. Miss Mrs. Ms. Prof. Dr. Male Female

Street Name Apartment Number Town or City   State/Province/County Zip/Postal Code Country Please Select: the United States Canada the United Kingdom Afghanistan Albania Algeria Amer.Samoa Andorra Angola Anguilla Antarctica Antigua and Barb. Argentina Armenia Aruba Australia Austria Azerbaijan the Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herz. Botswana Bouvet Island Brazil Br.Ind.Oc.Terr. Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde the Cayman Is. Cen.Afr.Rep. Chad Chile China Christmas Is. Cocos Is. Colombia Comoros Congo Cook Is. Costa Rica Croatia Cuba Cyprus Czech Rep. Denmark Djibouti Dominica Dom.Rep. East Timor Ecuador Egypt El Salvador Equ.Guinea Eritrea Estonia Ethiopia Falkland Is. Faroe Is. Fiji Islands Finland France Fr.Guiana Fr.Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea GuineaBissau Guyana Haiti Heard and McD.Is. Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau SAR Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Is. Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal the Netherlands Nlands Ant. N.Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea N.Mariana Is. Norway Oman Pakistan Palau Palestine - GazaPalestine - West Bank Panama Pap.N.Guinea Paraguay Peru the Philippines Pitcairn Is. Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda St. Kitts and Nevis St. Lucia St Vincent and Gr. Samoa San Marino S.Tome and Pr. Saudi Arabia Senegal the Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Is. Somalia South Africa Spain Sri Lanka St. Helena St.Pierre et Miq. Sudan Suriname Svalbard and JM Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trin. and Tobago Tunisia Turkey Turkmenistan Turks and C.Is. Tuvalu Uganda Ukraine the U.A.Emirates the United Kingdom the United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Viet Nam the Virgin Islands Wallis and Futuna Western Sahara Yemen Yugoslavia Zambia Zimbabwe   How long resident in this country? Telephone Number Business Telephone Select... Less than 1 year Longer than 1 year   E-mail Address Mobile/Cell Number Fax Number   Date of Birth City or Town of Birth Country of Birth 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jan Feb March April May June July Aug Sept Oct Nov Dec 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 Please Select: the United States Canada the United Kingdom Afghanistan Albania Algeria Amer.Samoa Andorra Angola Anguilla Antarctica Antigua and Barb. Argentina Armenia Aruba Australia Austria Azerbaijan the Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herz. Botswana Bouvet Island Brazil Br.Ind.Oc.Terr. Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde the Cayman Is. Cen.Afr.Rep. Chad Chile China Christmas Is. Cocos Is. Colombia Comoros Congo Cook Is. Costa Rica Croatia Cuba Cyprus Czech Rep. Denmark Djibouti Dominica Dom.Rep. East Timor Ecuador Egypt El Salvador Equ.Guinea Eritrea Estonia Ethiopia Falkland Is. Faroe Is. Fiji Islands Finland France Fr.Guiana Fr.Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea GuineaBissau Guyana Haiti Heard and McD.Is. Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau SAR Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Is. Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal the Netherlands Nlands Ant. N.Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea N.Mariana Is. Norway Oman Pakistan Palau Palestine - GazaPalestine - West Bank Panama Pap.N.Guinea Paraguay Peru the Philippines Pitcairn Is. Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda St. Kitts and Nevis St. Lucia St Vincent and Gr. Samoa San Marino S.Tome and Pr. Saudi Arabia Senegal the Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Is. Somalia South Africa Spain Sri Lanka St. Helena St.Pierre et Miq. Sudan Suriname Svalbard and JM Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trin. and Tobago Tunisia Turkey Turkmenistan Turks and C.Is. Tuvalu Uganda Ukraine the U.A.Emirates the United Kingdom the United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Viet Nam the Virgin Islands Wallis and Futuna Western Sahara Yemen Yugoslavia Zambia Zimbabwe   Marital Status No of Children / Ages List other countries in which you have legally resided for more than 1 year. Select Never Married Engaged Married Common-Law Same-Sex Partner Widowed Divorced Separated 0 1 2 3 4 5 6 7 8+