Student Evaluation | Polinsys- Canada Immigration

Student evaluation

survey form

Name :*
First Last
Date Of Birth :*
Country of Citizenship :*
Work Experience:
Are you currently employed?*
- Yes
- No
Name of Current Employer:*
Location of Employment:*
Job category:*
Job title:*
Job responsibility:*
Explain in your own words what this responsibility means to you:*
Employment From :*
MM slash DD slash YYYY
Employment To :*
MM slash DD slash YYYY
If you have previous employment experience, please click the checkbox and fill in your details beginning from the most current backwards.
- Add another employment experience.
Do you have any previous work experience?*
- Yes
- No
Name of Employer:*
Location of Employment:*
Job category:*
Job title:*
Job responsibility:*
Explain in your own words what this responsibility means to you:*
Employment From :*
MM slash DD slash YYYY
Employment To :*
MM slash DD slash YYYY
If you have previous employment experience, please click the checkbox and fill in your details beginning from the most current backwards.
- Add another employment experience.
Name of Employer:*
Location of Employment:*
Job category:*
Job title:*
Job responsibility:*
Explain in your own words what this responsibility means to you:*
Employment From :*
MM slash DD slash YYYY
Employment To :*
MM slash DD slash YYYY
If you have previous employment experience, please click the checkbox and fill in your details beginning from the most current backwards.
- Add another employment experience.
Name of Employer:*
Location of Employment:*
Job category:*
Job title:*
Job responsibility:*
Explain in your own words what this responsibility means to you:*
Employment From :*
MM slash DD slash YYYY
Employment To :*
MM slash DD slash YYYY
If you have previous employment experience, please click the checkbox and fill in your details beginning from the most current backwards.
- Add another employment experience.
Name of Employer:*
Location of Employment:*
Job category:*
Job title:*
Job responsibility:*
Explain in your own words what this responsibility means to you:*
Employment From :*
MM slash DD slash YYYY
Employment To :*
MM slash DD slash YYYY
Education:
Have you Completed Secondary School or 10th Grade?*
- Yes
- No
Secondary Course Details :
Name of Institution :*
Location (Address) :*
Country :*
Did you complete your course without Breaks?*
- Yes
- No
From :*
MM slash DD slash YYYY
To :*
MM slash DD slash YYYY
Explain the Break :*
If you have more breaks please Add the next break:*
- Yes
- No
From :*
MM slash DD slash YYYY
To :*
MM slash DD slash YYYY
Explain the Break :*
Did you pass all your exams in one sitting?*
- Yes
- No
How many subjects did you have to redo?*
Subject 1 :
Name of the subject:*
Date Completed :*
MM slash DD slash YYYY
Number of Additional Attempts:
Subject 2 :
Name of the subject:*
Date Completed :*
MM slash DD slash YYYY
Number of Additional Attempts:
Subject 3 :
Name of the subject:*
Date Completed :*
MM slash DD slash YYYY
Number of Additional Attempts:
Subject 4 :
Name of the subject:*
Date Completed :*
MM slash DD slash YYYY
Number of Additional Attempts:
Subject 5 :
Name of the subject:*
Date Completed :*
MM slash DD slash YYYY
Number of Additional Attempts:
Subject 6 :
Name of the subject:*
Date Completed :*
MM slash DD slash YYYY
Number of Additional Attempts:
What was your overall Score ?*
Have you done any diploma after 10th Grade?*
- Yes
- No
Diploma Details :
Name of Institution:*
Location (Address):*
Country:*
Name of Diploma:*
Duration of Diploma:*
Did you take any break while completing your diploma?*
- Yes
- No
From:*
MM slash DD slash YYYY
To:*
MM slash DD slash YYYY
Explain the break:*
If you have more breaks please Add the next break:*
- Yes
- No
From:*
MM slash DD slash YYYY
To:*
MM slash DD slash YYYY
Explain the break:*
Did you pass all your exams in one sitting while taking this diploma?*
- Yes
- No
How many subjects did you have to redo?*
Subject 1:
Name of the Subject:*
Date Completed:*
MM slash DD slash YYYY
Number of additional attempts
Subject 2:
Name of the Subject:*
Number of additional attempts
Subject 3:
Name of the Subject:*
Date Completed:*
MM slash DD slash YYYY
Number of additional attempts
Subject 4:
Name of the Subject:*
Date Completed:*
MM slash DD slash YYYY
Number of additional attempts
Subject 5:
Name of the Subject:*
Date Completed:*
MM slash DD slash YYYY
Number of additional attempts
Subject 6:
Name of the Subject:*
Date Completed:*
MM slash DD slash YYYY
Number of additional attempts
What is your overall score?*
Did you do any other diplomas in addition to the one indicated above after your 10th Grade?*
- Yes
- No
Additional diploma details :
Name of Institution:*
Location (Address):*
Country:*
Name of Diploma:*
Duration of Diploma:*
Did you take any break while completing your diploma?*
- Yes
- No
From:*
MM slash DD slash YYYY
To:*
MM slash DD slash YYYY
Explain the break:*
If you have more breaks please Add the next break:*
- Yes
- No
From:*
MM slash DD slash YYYY
To:*
MM slash DD slash YYYY
Explain the break:*
Did you pass all your exams in one sitting while taking this diploma?*
- Yes
- No
How many subjects did you have to redo?*
Subject 1:
Name of the Subject:*
Date Completed:*
MM slash DD slash YYYY
Number of additional attempts
Subject 2:
Name of the Subject:*
Date Completed:*
MM slash DD slash YYYY
Number of additional attempts
Subject 3:
Name of the Subject:*
Date Completed:*
MM slash DD slash YYYY
Number of additional attempts
Subject 4:
Name of the Subject:*
Date Completed:*
MM slash DD slash YYYY
Number of additional attempts
Subject 5:
Name of the Subject:*
Date Completed:*
MM slash DD slash YYYY
Number of additional attempts
Subject 6:
Name of the Subject:*
Date Completed:*
MM slash DD slash YYYY
Number of additional attempts
What was your overall score?*
Have you completed Post Secondary School or 12th Grade?*
- Yes
- No
Have you done graduation without Post Secondary?*
- Yes
- No
Post Secondary Course Details:
Name of Institution:*
Location (Address) :*
Country:*
Duration: From:*
To:*
Did you take any break while completing your course?*
- Yes
- No
From :*
MM slash DD slash YYYY
To:*
MM slash DD slash YYYY
Explain the break:*
If you have more breaks please Add the next break:*
- Yes
- No
From :*
MM slash DD slash YYYY
To:*
MM slash DD slash YYYY
Explain the break:*
Did you pass all your exams in one sitting?*
- Yes
- No
How many subjects did you have to redo?*
Subject 1:
Name of the subject:*
Date Completed:*
MM slash DD slash YYYY
Number of additional attempts
Subject 2:
Name of the subject:*
Date Completed:*
MM slash DD slash YYYY
Number of additional attempts
Subject 3:
Name of the subject:*
Date Completed:*
MM slash DD slash YYYY
Number of additional attempts
Subject 4:
Name of the subject:*
Date Completed:*
MM slash DD slash YYYY
Number of additional attempts
Subject 5:
Name of the subject:*
Date Completed:*
MM slash DD slash YYYY
Number of additional attempts
Subject 6:
Name of the subject:*
Date Completed:*
MM slash DD slash YYYY
Number of additional attempts
What was your overall score?*
Have you done any diploma after 12th Grade?*
- Yes
- No
Diploma Details:
Name of Institution:*
Address of Institution:*
Country:*
Name of Diploma:*
Duration of Diploma:*
Did you take a break while completing your diploma?*
- Yes
- No
From :*
MM slash DD slash YYYY
To:*
MM slash DD slash YYYY
Explain the break:*
If you have more breaks please Add the next break:*
- Yes
- No
From :*
MM slash DD slash YYYY
To:*
MM slash DD slash YYYY
Explain the break:*
Did you pass all your exams in one sitting while taking this diploma?*
- Yes
- No
How many subjects did you have to redo?*
Subject 1:
Name of the subject:*
Date Completed:*
MM slash DD slash YYYY
Number of additional attempts
Subject 2:
Name of the subject:*
Date Completed:*
MM slash DD slash YYYY
Number of additional attempts
Subject 3:
Name of the subject:*
Date Completed:*
MM slash DD slash YYYY
Number of additional attempts
Subject 4:
Name of the subject:*
Date Completed:*
MM slash DD slash YYYY
Number of additional attempts
Subject 5:
Name of the subject:*
Date Completed:*
MM slash DD slash YYYY
Number of additional attempts
Subject 6:
Name of the subject:*
Date Completed:*
MM slash DD slash YYYY
Number of additional attempts
What was your overall score?*
Did you do any other diplomas in addition to the one indicated above after your 12th Grade?*
- Yes
- No
Additional diploma details
Name of Institution:*
Address of Institution:*
Country:*
Name of Diploma:*
Duration of Diploma:*
Did you take a break while completing your diploma?*
- Yes
- No
From:*
MM slash DD slash YYYY
To:*
MM slash DD slash YYYY
Explain the break:*
If you have more breaks please Add the next break:*
- Yes
- No
From:*
MM slash DD slash YYYY
To:*
MM slash DD slash YYYY
Explain the break:*
Did you pass all your exams in one sitting while taking this diploma?*
- Yes
- No
How many subjects did you have to redo?*
Subject 1:
Name of the subject:*
Date Completed:*
MM slash DD slash YYYY
Number of additional attempts
Subject 2:
Name of the subject:*
Date Completed:*
MM slash DD slash YYYY
Number of additional attempts
Subject 3:
Name of the subject:*
Date Completed:*
MM slash DD slash YYYY
Number of additional attempts
Subject 4:
Name of the subject:*
Date Completed:*
MM slash DD slash YYYY
Number of additional attempts
Subject 5:
Name of the subject:*
Date Completed:*
MM slash DD slash YYYY
Number of additional attempts
Subject 6:
Name of the subject:*
Date Completed:*
MM slash DD slash YYYY
Number of additional attempts
What was your overall score?*
Have you done Bachelor Program (Completed or in progress)?*
- Yes
- No
Bachelor Program (Completed or in progress)
Did you complete your Bachelor Program?*
- Yes
- No
Name of Bachelor Program:*
Name of Institution:*
Address of Institution:*
Country:*
Medium of Instruction:*
Did you have any additional languages as part of course?*
- Yes
- No
Select Language:*
Total duration of Bachelor Program:*
Duration you studied:*
Specialization and auxiliary subjects:*
Did you take a break while completing your Bachelor?*
- Yes
- No
From:*
MM slash DD slash YYYY
To:*
MM slash DD slash YYYY
Explain the break:*
Do you take more break other than the one indicated above?*
- Yes
- No
From:*
MM slash DD slash YYYY
To:*
MM slash DD slash YYYY
Explain the break:*
Did you pass all your exams in one sitting while taking your Bachelor Program?*
- Yes
- No
How many subjects did you have to redo?*
Subject 1:
Name of Subject:*
Date of Completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 2:
Name of Subject:*
Date of Completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 3:
Name of Subject:*
Date of Completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 4:
Name of Subject:*
Date of Completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 5:
Name of Subject:*
Date of Completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 6:
Name of Subject:*
Date of Completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 7:
Name of Subject:*
Date of Completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 8:
Name of Subject:*
Date of Completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 9:
Name of Subject:*
Date of Completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 10:
Name of Subject:*
Date of Completion:*
MM slash DD slash YYYY
Number of additional attempts:
What is your overall score?*
Have you done any additional bachelor program?*
- Yes
- No
Additional bachelor program (completed or in progress)
Did you complete your Bachelor Program?*
- Yes
- No
Name of Institution:*
Address of Institution:*
Country:*
Medium of Instruction:*
Did you have any additional languages as part of your course ?*
- Yes
- No
Select Language:*
Total duration of Bachelor Program:*
Duration you studied:*
Specialization and auxiliary subjects:*
Did you take a break while completing your Bachelor?*
- Yes
- No
From:*
MM slash DD slash YYYY
To:*
MM slash DD slash YYYY
Explain the break:*
Did you take more break other than the one indicated above?*
- Yes
- No
From:*
MM slash DD slash YYYY
To:*
MM slash DD slash YYYY
Explain the break:*
Did you pass all your exams in one sitting while taking your Bachelor Program?*
- Yes
- No
How many subjects did you have to redo?*
Subject 1:
Name of Subject:*
Date of Completion:*
MM slash DD slash YYYY
Number of additional Attempts:
Subject 2:
Name of Subject:*
Date of Completion:*
MM slash DD slash YYYY
Number of additional Attempts:
Subject 3:
Name of Subject:*
Name of Subject:*
Date of Completion:*
MM slash DD slash YYYY
Number of additional Attempts:
Subject 4:
Name of Subject:*
Date of Completion:*
MM slash DD slash YYYY
Number of additional Attempts:
Subject 5:
Name of Subject:*
Date of Completion:*
MM slash DD slash YYYY
Number of additional Attempts:
Subject 6:
Name of Subject:*
Date of Completion:*
MM slash DD slash YYYY
Number of additional Attempts:
Subject 7:
Name of Subject:*
Date of Completion:*
MM slash DD slash YYYY
Number of additional Attempts:
Subject 8:
Name of Subject:*
Date of Completion:*
MM slash DD slash YYYY
Number of additional Attempts:
Subject 9:
Name of Subject:*
Date of Completion:*
MM slash DD slash YYYY
Number of additional Attempts:
Subject 10:
Name of Subject:*
Date of Completion:*
MM slash DD slash YYYY
Number of additional Attempts:
What was your overall score?*
Have you completed any Masters Program?*
- Yes
- No
Masters Program (Completed or in Progress)
Did you complete your masters program?*
- Yes
- No
Name of Masters Program:*
Address of Institution:*
Country:*
Medium of Instruction:*
Did you have any additional languages as part of course?*
- Yes
- No
Select Language:*
Total duration of Masters Program:*
Duration you studied:*
Specialization and auxiliary subjects:*
Did you take a break while completing your Masters?*
- Yes
- No
From:*
MM slash DD slash YYYY
To:*
MM slash DD slash YYYY
Explain the break:*
Did you take more break other than the one indicated above?*
- Yes
- No
From:*
MM slash DD slash YYYY
To:*
MM slash DD slash YYYY
Explain the break:*
Did you pass all your exams in one sitting while taking your Masters Program?*
- Yes
- No
How many subjects did you have to redo?*
Subject 1:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 2:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 3:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 4:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 5:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 6:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 7:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 8:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 9:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 10:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
What was your overall score?*
Have you done any additional masters program?*
- Yes
- No
Additional masters program (completed or in-progress)
Did you complete your masters program?*
- Yes
- No
Name of Masters Program:*
Address of Institution:*
Country:*
Medium of Instruction:*
Did you have any additional languages as part of course?*
- Yes
- No
Select Language:*
Total duration of Masters Program:*
Duration you studied:*
Specialization and auxiliary subjects:*
Did you take a break while completing your Masters?*
- Yes
- No
From:*
MM slash DD slash YYYY
To:*
MM slash DD slash YYYY
Explain the break:*
Do you take more break other than the one indicated above?*
- Yes
- No
From:*
MM slash DD slash YYYY
To:*
MM slash DD slash YYYY
Explain the break:*
Did you pass all your exams in one sitting while taking your Masters Program?*
- Yes
- No
How many subjects did you have to redo?*
Subject 1:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 2:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 3:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 4:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 5:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 6:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 7:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 8:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 9:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 10:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
What was your overall score?*
Have you done any Doctoral program?*
- Yes
- No
Doctoral program
Did you complete your doctoral program?*
- Yes
- No
Specialization:*
Name of Institution:*
Address of Instituion:*
Country:*
Medium of Instruction:*
Total duration of doctoral program:*
Duration you studied:*
Specialization and auxiliary subjects:*
Did you take a break while completing your doctoral?*
- Yes
- No
From:*
MM slash DD slash YYYY
To:*
MM slash DD slash YYYY
Explain the break:*
Did you take more breaks other than the one indicated above?*
- Yes
- No
From:*
MM slash DD slash YYYY
To:*
MM slash DD slash YYYY
Explain the break:*
Did you pass all your exams in one sitting while taking your doctoral program?*
- Yes
- No
How many subjects did you have to redo?*
Subject 1:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 2:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 3:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 4:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 5:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 6:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 7:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 8:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 9:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 10:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
What was your overall score?*
Have you done any additional doctoral program?*
- Yes
- No
Additional doctoral program
Did you complete your doctoral program?*
- Yes
- No
Specialization:*
Name of Institution:*
Address of Instituion:*
Country:*
Medium of Instruction:*
Total duration of doctoral program:*
Duration you studied:*
Specialization and auxiliary subjects:*
Did you take a break while completing your doctoral?*
- Yes
- No
From:*
MM slash DD slash YYYY
To:*
MM slash DD slash YYYY
Explain the break:*
Did you take more breaks other than the one indicated above?*
- Yes
- No
From:*
MM slash DD slash YYYY
To:*
MM slash DD slash YYYY
Explain the break:*
Did you pass all your exams in one sitting while taking your doctoral program?*
- Yes
- No
How many subjects did you have to redo?*
Subject 1:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 2:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 3:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 4:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 5:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 6:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 7:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 8:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 9:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
Subject 10:
Name of subject:*
Date of completion:*
MM slash DD slash YYYY
Number of additional attempts:
What was your overall score?*
Language:
Have you completed your IELTS?*
- Yes
- No
Until when is your result valid?*
MM slash DD slash YYYY
How much did you score?
Reading:*
Writing:*
Speaking:*
Listening:*
Overall:*
Explain in a few words if you have any specific course or career track in your mind:*

survey form

Work Experience:

Education:

Secondary Course Details :

Subject 1 :

Subject 2 :

Subject 3 :

Subject 4 :

Subject 5 :

Subject 6 :

Diploma Details :

Subject 1:

Subject 2:

Subject 3:

Subject 4:

Subject 5:

Subject 6:

Additional diploma details :

Subject 1:

Subject 2:

Subject 3:

Subject 4:

Subject 5:

Subject 6:

Post Secondary Course Details:

Subject 1:

Subject 2:

Subject 3:

Subject 4:

Subject 5:

Subject 6:

Diploma Details:

Subject 1:

Subject 2:

Subject 3:

Subject 4:

Subject 5:

Subject 6:

Additional diploma details

Subject 1:

Subject 2:

Subject 3:

Subject 4:

Subject 5:

Subject 6:

Bachelor Program (Completed or in progress)

Subject 1:

Subject 2:

Subject 3:

Subject 4:

Subject 5:

Subject 6:

Subject 7:

Subject 8:

Subject 9:

Subject 10:

Additional bachelor program (completed or in progress)

Subject 1:

Subject 2:

Subject 3:

Subject 4:

Subject 5:

Subject 6:

Subject 7:

Subject 8:

Subject 9:

Subject 10:

Masters Program (Completed or in Progress)

Subject 1:

Subject 2:

Subject 3:

Subject 4:

Subject 5:

Subject 6:

Subject 7:

Subject 8:

Subject 9:

Subject 10:

Additional masters program (completed or in-progress)

Subject 1: