Stepwheel Outsourcing Pvt. Ltd.

Website : www.stepwheel.in

Technical Assessment Form

1. Your Contact Information:
First Name: Middle Name:

Last Name:

Email Address:

Residence Address

Telephone: (Include Country or City code)

Nationality:

2. Your Personal Profile:

Date of Birth:
Age:
Marital Status:

Have you previously been married or in a common law relationship?

3. What is your Country of Birth :

4. The country where you are currently located?

5. What is your preferred destination in Abroad?

 6. Do you have any Dependent Children?

7. Have you previously submitted a visa application? Yes /No

8. Your Personal Net Worth :
(Your Personal Net Worth is the current value of all the assets (e.g. properties,
investments, stocks, bonds, bank accounts) that you (and your spouse/common-law
partner, if applicable) personally own, MINUS the current value of all your combined
personal liabilities (e.g. mortgages, loans, credit card balances).
Please be sure to include your share of the value of any businesses that you own.

Annual Income (INR):

9. Your Language Skills:

Speak Read Write Listen

English:
French:

10. Education:

Course Detail Part/Full Start Date End Date

Time
PHD (Regular/Correspondence):

Master Degree (Regular/Correspondence):

Bachelor Degree (Regular/Correspondence):

Other Diploma/Certificate
(Regular/Correspondence):
10th& 12th (Regular/Correspondence):
11.Your Work History:

Have you ever worked in any other country in a skilled occupation for at least
one year?
Yes /No

Have you done any paid work anywhere in the world during the last 10
years?
Yes No

Total Years of Work Experience:

DETAILS OF WORK EXPERIENCE

Company Name Designation Start Date End Date Duration Cou
(Years) ntry
Employment 1

Employment 2

Employment 3

Employment 4

Employment 5

Additional Information:-

11. Do you have an abroad Job Offer:

Yes / No
12. Family and Friends in Any other country:

Do you have any family members, relatives, or close friends living in abroad?
Yes / No

Which country do they reside:

13. Do you have any criminal records? If Yes, Explain:

14. Have you ever refused any visa? If Yes, Explain:

15. Are you able to obtain a clean Police Clearance Record with no criminal
record?
Yes No

16. Do you have any medical problem? If Yes, Explain: