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Free Business Assesstment Form
  • Areas marked with an * are required fields
  • Remember to click the "Submit" button at the bottom of the screen when you have finished filling out the form
Personal Information
Your Name*
Date of Birth*
Nationality*
Address: Number and Street*
City/Town*
State/Province*
Country*
Post Code/Zip Code*
Telephone Number*
Fax Number
E-Mail Address*
Level of Education
High School Diploma
 
Trade School/College Diploma
 
Bachelor Degree
 
Master Degree
 
PH. D. Degree
 
Total years of full-time study in school
Official Languages
ENGLISH High Proficiency Moderate Proficiency Basic Proficiency No ability to speak
Speak
Listen
Read
Write
FRENCH High Proficiency Moderate Proficiency Basic Proficiency No ability to speak
Speak
Listen
Read
Write
Legally Obtained Net Worth
My net worth is less than $CAN 300,000.00
My net worth is between $CAN 300,000.00 and $CAN 800,000.00
My net worth is between $CAN 800,000.00 and $CAN 1,000,000.00
My net worth is greater than $CAN 1,000,000.00
Business Experience
I own and manage a business in the past five years
I manage a business in the past five years
I am a farmer and planning to purchase a farm in Canada
I am involved in art/athletic business activities
I am a world class athlete/artist
Please fill out the below table about your business performance in the past five years:
  Year 1 Year 2 Year 3 Year 4 Year 5
Sales CN$
Net Income CN$
Net Assets CN$
Number Employees
Any additional comments you would like to make

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