Canadian Immigration Assessment Form

1 - Personal Information
Name: Gerald Sevilla Casco Date of Birth : April 06, 1993 Sex !ale"#emale$: !ale Co%tact N&m'er: 09169(6)6(( *mail: +er,casco-.ahoo,com

2 - Family Composition
/rese%t marital Stat&s: Si%+le N&m'er of Childre% 0ith A+e: N"A

D&ratio% 3 Education #rom $

June 200

Academic, 6o mo%th".ear $
April 2013

Colle+e Co&rse 1 /rofessio%al 2&alificatio%

!ac"elor of #cience in $ursing

mo%th".ear

!ar3s 4'tai%ed

Name of School"5%iversit. 0ith co&%tr.

%ni&ersity of t"e East 'amon (agsaysay (emorial (edical Center

Finis"ed

) - *or+ ,istory
6otal %&m'er of .ears of experie%ce 0ith complete histor. of past 10 .ears: D&ratio% #rom 6o Name of the Desi+%atio% a%d =o' /rofile mo%th".ear mo%th".ear Compa%. please i%dicate if it is paid or %ot paid$ $ $

- - A.ility in /anguage E$0/I#,: 7i+h"!oderate"Basic"No%e$ !e%tio% 8*96S res&lts

S/*A:8NG: !oderate 98S6*N8NG: !oderate ;*AD8NG: !oderate <;868NG: !oderate

1 - A.ility in /anguage F'E$C,: 7i+h"!oderate"Basic"No%e$

S/*A:8NG: No%e 98S6*N8NG: No%e ;*AD8NG: No%e <;868NG: No%e

Information on #pouse 2Applicant3s ,us.and or *ife4

Name: Date of Birth : Sex !ale"#emale$:

5 Education
D&ratio% #rom mo%th".ear $ 6o mo%th".ear $ Academic, Colle+e Co&rse 1 /rofessio%al 2&alificatio% !ar3s 4'tai%ed Name of School"5%iversit. 0ith co&%tr.

6- A.ility in /anguage E$0/I#,: 7i+h"!oderate"Basic"No%e$ !e%tio% 8*96S res&lts

S/*A:8NG: 98S6*N8NG: ;*AD8NG: <;868NG:

- A.ility in /anguage F'E$C,: 7i+h"!oderate"Basic"No%e$

S/*A:8NG: 98S6*N8NG: ;*AD8NG: <;868NG:

10 - *or+ ,istory of #pouse

6otal %&m'er of .ears of experie%ce 0ith complete histor. of past 10 .ears: D&ratio% #rom 6o Name of the Desi+%atio% a%d =o' /rofile mo%th".ear mo%th".ear Compa%. please i%dicate if it is paid or %ot paid$ $ $

11: A%. self>emplo.ed professio% '. applica%t or spo&se d&ri%+ last ? .ears@

Si+%at&re of Staff: Ms CINDY MANLAPAZ Name of 4ffice: WeConnect Immigration Consultants, Inc (Manila, Philippines)