PEOPLE FOR CANADA, INC.

APPLICATION FORM

to register on the PFC Potential Employees Database

-Complete all fields on this form by typing in your answers.

-Do not try to reformat the form.

-If additional space is needed, use the Additional Info section.

-Make sure your email address and phone number are correct as we will rely on them to contact you.

-Save this application form as an MS Word document (.doc file) and name it in the following format: LastName_FirstName.doc

-Submit the completed and saved form as an attachment to

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Personal Details

Salutation: Mr/Ms/Mrs/Dr / Last Name / Middle Name (if applicable) / First Name
Address / Village / City / Postal Code / Country
Phone (incl. country code) / Alternative (other) Phone / E-Mail Address
Date of Birth (dd-mm-yyyy) / Place of Birth (City, Country) / Country of Citizenship

Education History

List all of the secondary, post-secondary (university), and vocational training and education you have received, starting with the most recent.

Name of Institution / City, Country / Program/Field of Study / Attendance from mm-yyyy to mm-yyyy / Credential Earned: Diploma, Certificate, Degree,

Work Experience

List all your work experience, including your current position and any previous jobs you have held.

Name of Company / City, Country / Job Title / Duration of job from mm-yyyy to mm-yyyy

English / French Language Ability

Choose a level of English / French language ability that best corresponds with you. Put the number corresponding to your level of ability in each of the four categories (reading, writing, speaking, and understanding).

0 = No ability, 1 = Basic, 2 = Pre-intermediate, 3 = Intermediate, 4 = Upper-intermediate, 5 = Advanced, 6 = Fluent

Level of English / Reading / Writing / Speaking / Understanding
Level of French / Reading / Writing / Speaking / Understanding

IELTS Results

If you have ever taken the International English Language Testing System (IELTS) General Test, please provide the following information.

Date of Test (dd-mm-yyyy) / Overall Score / Reading / Speaking / Writing / Listening

Family Members

List all of your immediate family members (spouse and children if applicable).

Full Name of Family Member / Date of Birth (dd-mm-yyy) / Relationship to You / Occupation

Additional Info

List here any other relevant information – such as particular skills you may have, awards or prizes you may have won in your education and career, etc.

Electronic Signature

By filling in and submitting this form, I give permission to People for Canada, Inc. to use my information for the purpose of helping me find eventual employment in Canada. I also give permission to People for Canada, Inc. to verify any of the information provided herein by directly contacting any of the relevant authorities. By typing in my name and date below and by sending this completed form via email to , I am considered to have actually signed this document electronically.

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Full NameDate

This application form and the service offered through it are provided on a free basis. No one can ask you to pay any fees whatsoever related to the service of applying with PFC in search of potential employment in Canada.