Submit Your Information For Application *Please do not submit this form until you are asked to do so Type of Application You Are Applying for Temporary Resident Visa (TRV) Application Visitor Record Extension Work Permit Application Open Work Permit Application (i.e. Spouse of a Skilled Worker or International Student) Study Permit Application Working Holiday Visa Permanent Residency Application Family Sponsorship Application Super Visa Rehabilitation Application Other Your Information First Name(required) Middle Name Last Name(required) Name in Your Native Language (i.e. 张伟) Your Gender Select one(required) Male Female Other Your Date of Birth (required) Your Citizenship 1st(required) 2nd 3rd Your Contact Information Phone Number #1 Is the Phone Number #1 Landline or Cellular? Landline Cellular Phone Number #2 Is the Phone Number #2 Landline or Cellular? Landline Cellular Email Address(required) Your Current Residential Address P.O. Box Apt/Unit Street Number Street Name City Country Postal Code Your Other Address P.O. Box Apt/Unit Street Number Street Name City Country Postal Code Your Eye Colour Select one(required) Black Blue Brown Green Grey Hazel Pink Sea Green Other Your Height Cm Or ft in Your Passport Information Passport Number(required) Place of Birth (as stated in Passport) (required) Passport Issue date (required) Passport expiry date (required) Your Current Canadian Visa Status (required) None Visitor Work Permit Holder Open Work Permit Holder Study Permit Holder Refugee Claimant Issue Date of Your Current Canadian Visa or Status Expiry Date of Your Current Canadian Visa or Status Admissibility Questions Please check the box(es) if yes (1) Have you ever committed, been arrested for or been charged with or convicted of any criminal offence in any country, or are you currently on trial for or subject of any criminal proceedings in any country? (Including drunk driving) (2) Have you been refused of refugee status, or permanent residency application in Canada? (3) Have you been refused to enter, or ordered to leave, Canada or any other country? (4) Have you been refused to be issued with any visa or permit before? (5) Have you been detained, incarcerated or put in jail? (6) Have you ever overstayed in Canada or any other country? (7) Have you previously made claims for refugee protections in Canada or at a Canadian visa office abroad, in any other countries, or to the United Nations High Commissioner for Refugees (UNHCR)? (8) Have you been and/or would you be involved in an act of genocide, war crime, commission of a crime against humanity, organized crime, transnational crime or violation of human rights? (9) Have you engaged in an act of espionage, subversion of any government, terrorism or violence? Have you ever been a member of an organization that has engaged or may engage in aforementioned acts or acts similar to those? (10) Do you have any physical or mental disorder that require social and/or health assistance other than medication during a stay in Canada? (11) Have you or a family member ever had tuberculosis of the lungs or been in close contact with a person with tuberculosis? Do you or your family member have medical condition that is likely to be a danger to public safety? (12) Are you a lawful permanent resident of United States? (13) Have you been refused of Provincial Nominee Application before? If you checked any of these questions, please provide details Spouse’s information Yes I have a spouse. First Name Middle Name Last Name Name in Your Native Language (i.e. 张伟) Spouse’s Gender Select one Male Female Other Spouse’s Date of Birth Check the box if this person is deceased. If this person is deceased, provide the date of death. If this person is deceased, provide the place of death (i.e. City and Country) Spouse’s Current Occupation Spouse’s Current Address The same as my current address P.O. Box Apt/Unit Street Number Street Name City Country Postal Code Spouse’s Passport Information Passport Number Place of Birth (as stated in Passport) Passport Issue date Passport expiry date Spouse’s Current Canadian Visa Status Select one None Visitor Work Permit Holder Open Work Permit Holder Study Permit Holder Refugee Claimant Issue Date of the Current Canadian Visa or Status Expiry Date of the Current Canadian Visa or Status 1st Child’s information Yes I have a child First Name Middle Name Last Name Name in Your Native Language (i.e. 张伟) 1st Child’s Date of Birth Check the box if this person is deceased. If this person is deceased, provide the date of death. If this person is deceased, provide the place of death. 1st Child’s Gender Select one Male Female Other 1st Child’s Current Address The same as my current address P.O. Box Apt/Unit Street Number Street Name City Country Postal Code 1st Child’s Marital Status Select one Married Single Divorced Widowed Annulled Marriage 1st Child’s Current Occupation 1st Child’s Passport Information Passport Number Place of Birth (as stated in Passport) Passport Issue date Passport expiry date 1st Child’s Current Canadian Visa Status Select one None Visitor Work Permit Holder Open Work Permit Holder Study Permit Holder Refugee Claimant Issue Date of the Current Canadian Visa or Status Expiry Date of the Current Canadian Visa or Status 2nd Child’s information Yes I have 2nd child First Name Middle Name Last Name Name in Your Native Language (i.e. 张伟) 2nd Child’s Date of Birth Check the box if this person is deceased. If this person is deceased, provide the date of death. If this person is deceased, provide the place of death. 2nd Child’s Gender Select one Male Female Other 2nd Child’s Current Address The same as my current address P.O. Box Apt/Unit Street Number Street Name City Country Postal Code 2nd Child’s Marital Status Select one Married Single Divorced Widowed Annulled Marriage 2nd Child’s Current Occupation 2nd Child’s Passport Information Passport Number Place of Birth (as stated in Passport) Passport Issue date Passport expiry date 2nd Child’s Current Canadian Visa Status Select one None Visitor Work Permit Holder Open Work Permit Holder Study Permit Holder Refugee Claimant Issue Date of the Current Canadian Visa or Status Expiry Date of the Current Canadian Visa or Status 3rd Child’s information Yes I have 3rd child First Name Middle Name Last Name Name in Your Native Language (i.e. 张伟) 3rd Child’s Date of Birth Check the box if this person is deceased. If this person is deceased, provide the date of death. If this person is deceased, provide the place of death. 3rd Child’s Gender Select one Male Female Other 3rd Child’s Current Address The same as my current address P.O. Box Apt/Unit Street Number Street Name City Country Postal Code 3rd Child’s Marital Status Select one Married Single Divorced Widowed Annulled Marriage 3rd Child’s Current Occupation 3rd Child’s Passport Information Passport Number Place of Birth (as stated in Passport) Passport Issue date Passport expiry date 3rd Child’s Current Canadian Visa Status Select one None Visitor Work Permit Holder Open Work Permit Holder Study Permit Holder Refugee Claimant Issue Date of the Current Canadian Visa or Status Expiry Date of the Current Canadian Visa or Status Additional Child(ren)’s Information Do you have more child(ren)? If yes, check the box and provide information below Your Mother’s information First Name Middle Name Last Name Name in Your Native Language (i.e. 张伟) Your Mother’s City and Country of Birth City Country Your Mother’s Gender Select one Male Female Other Your Mother’s Date of Birth Check the box if this person is deceased. If this person is deceased, provide the date of death. If this person is deceased, provide the place of death. Your Mother’s Contact Information E-mail Address Your Mother’s Current Occupation Your Mother’s Current Address The same as my current address P.O. Box Apt/Unit Street Number Street Name City Country Postal Code Your Mother’s Marital Status Select one Married Single Divorced Widowed Annulled Marriage Your Mother’s Current Canadian Visa Status Select one(required) None Visitor Work Permit Holder Open Work Permit Holder Study Permit Holder Refugee Claimant Issue Date of the Current Canadian Visa or Status Expiry Date of the Current Canadian Visa or Status Your Father’s information First Name Middle Name Last Name Name in Your Native Language (i.e. 张伟) Your Father’s Contact Information E-mail Address Your Father’s City and Country of Birth City Country Your Father’s Date of Birth Check the box if this person is deceased. If this person is deceased, provide the date of death. If this person is deceased, provide the place of death. Your Father’s Gender Select one Male Female Other Your Father’s Current Address The same as my current address P.O. Box Apt/Unit Street Number Street Name City Country Postal Code Your Father’s Marital Status Select one Married Single Divorced Widowed Annulled Marriage Your Father’s Current Occupation Your Father’s Current Canadian Visa Status Select one None Visitor Work Permit Holder Open Work Permit Holder Study Permit Holder Refugee Claimant Issue Date of the Current Canadian Visa or Status Expiry Date of the Current Canadian Visa or Status Your 1st sibling’s information First Name Middle Name Last Name Name in Your Native Language (i.e. 张伟) Your 1st sibling’s Contact Information E-mail Address Your 1st sibling’s Date of Birth Check the box if this person is deceased. If this person is deceased, provide the date of death. If this person is deceased, provide the place of death. Your 1st sibling’s Current Canadian Visa Status Select one None Visitor Work Permit Holder Open Work Permit Holder Study Permit Holder Refugee Claimant Issue Date of the Current Canadian Visa or Status Expiry Date of the Current Canadian Visa or Status Your 1st sibling’s Gender Select one Male Female Other Your 1st sibling’s City and Country of Birth City Country Your 1st sibling’s Current Address The same as my current address P.O. Box Apt/Unit Street Number Street Name City Country Postal Code Your 1st sibling’s Marital Status Select one Married Single Divorced Widowed Annulled Marriage Your 1st sibling’s Current Occupation Your 2nd sibling’s information First Name Middle Name Last Name Name in Your Native Language (i.e. 张伟) Your 2nd sibling’s Contact Information E-mail Address Your 2nd sibling’s Date of Birth Check the box if this person is deceased. If this person is deceased, provide the date of death. If this person is deceased, provide the place of death. Your 2nd sibling’s Current Canadian Visa Status Select one None Visitor Work Permit Holder Open Work Permit Holder Study Permit Holder Refugee Claimant Issue Date of the Current Canadian Visa or Status Expiry Date of the Current Canadian Visa or Status Your 2nd sibling’s Gender Select one Male Female Other Your 2nd sibling’s City and Country of Birth City Country Your 2nd sibling’s Current Address The same as my current address P.O. Box Apt/Unit Street Number Street Name City Country Postal Code Your 2nd sibling’s Marital Status Select one Married Single Divorced Widowed Annulled Marriage Your 2nd sibling’s Current Occupation Your 3rd sibling’s information First Name Middle Name Last Name Name in Your Native Language (i.e. 张伟) Your 3rd sibling’s Contact Information E-mail Address Your 3rd sibling’s Date of Birth Check the box if this person is deceased. If this person is deceased, provide the date of death. If this person is deceased, provide the place of death. Your 3rd sibling’s Current Canadian Visa Status Select one None Visitor Work Permit Holder Open Work Permit Holder Study Permit Holder Refugee Claimant Issue Date of the Current Canadian Visa or Status Expiry Date of the Current Canadian Visa or Status Your 3rd sibling’s Gender Select one Male Female Other Your 3rd sibling’s City and Country of Birth City Country Your 3rd sibling’s Current Address The same as my current address P.O. Box Apt/Unit Street Number Street Name City Country Postal Code Your 3rd sibling’s Marital Status Select one Married Single Divorced Widowed Annulled Marriage Your 3rd sibling’s Current Occupation Additional sibling’s Information Do you have more than 3 siblings? If yes, check the box and provide information below Have you ever applied for a Canadian visa or permanent residency? (i.e. Study, visitor, work permit, provincial nominee, federal economic immigration program application.) #1 Type (Visa or immigration) Select one Tourism Study Work Business Visit Refugee Claim Family Visit Other Specify the reason if you selected "Other" Select one Approved Refused Currently In Progress File # From (YYYY, MM, DD) To (YYYY, MM, DD) #2 Type (Visa or immigration) Select one Tourism Study Work Business Visit Refugee Claim Family Visit Other Specify the reason if you selected "Other" Select one Approved Refused Currently In Progress File # From (YYYY, MM, DD) To (YYYY, MM, DD) #3 Type (Visa or immigration) Select one Tourism Study Work Business Visit Refugee Claim Family Visit Other Specify the reason if you selected "Other" Select one Approved Refused Currently In Progress File # From (YYYY, MM, DD) To (YYYY, MM, DD) #4 Type (Visa or immigration) Select one Tourism Study Work Business Visit Refugee Claim Family Visit Other Specify the reason if you selected "Other" Select one Approved Refused Currently In Progress File # From (YYYY, MM, DD) To (YYYY, MM, DD) #5 Type (Visa or immigration) Select one Tourism Study Work Business Visit Refugee Claim Family Visit Other Specify the reason if you selected "Other" Select one Approved Refused Currently In Progress File # From (YYYY, MM, DD) To (YYYY, MM, DD) Additional Information Have you applied for more than 5 Canadian visas and/or permits? If yes, check the box and provide details below. Date of your original entry to Canada Original Entry Place of Entry (i.e. Vancouver International Airport) Select one Tourism Family visit Work Study Refugee Claim Business Other If you choose "Other," please provide detail Date of your most recent entry to Canada The same as above If not the same. please provide following information Most Recent Entry Place of Entry (i.e. Vancouver International Airport) Select one Tourism Family visit Work Study Refugee Claim Business Other If you choose "Other," please provide detail Education History (Please include primary school, secondary school, university, college, trade school and apprenticeship training, you have completed or plan to complete in the near future) *In chronological order. (i.e. new to old) Most recent From To Years of study (i.e. 4 year degree) Name of school/facility City, province and country Field and level of study (e.g. University/science) Certificate and diploma issued ECA # 2nd recent From To Years of study (i.e. 4 year degree) Name of school/facility City, province and country Field and level of study (e.g. University/science) Certificate and diploma issued ECA # 3rd recent From To Years of study (i.e. 4 year degree) Name of school/facility City, province and country Field and level of study (e.g. University/science) Certificate and diploma issued ECA # 4th recent From To Years of study (i.e. 4 year degree) Name of school/facility City, province and country Field and level of study (e.g. University/science) Certificate and diploma issued ECA # 5th recent From To Years of study (i.e. 4 year degree) Name of school/facility City, province and country Field and level of study (e.g. University/science) Certificate and diploma issued ECA # 6th recent From To Years of study (i.e. 4 year degree) Name of school/facility City, province and country Field and level of study (e.g. University/science) Certificate and diploma issued ECA # 7th recent From To Years of study (i.e. 4 year degree) Name of school/facility City, province and country Field and level of study (e.g. University/science) Certificate and diploma issued ECA # 8th recent From To Years of study (i.e. 4 year degree) Name of school/facility City, province and country Field and level of study (e.g. University/science) Certificate and diploma issued ECA # Additional Information Do you have more than 8 education history? If yes, check the box and provide details below. Provide details of your work history of the last 10 years or since the age of 18, whichever is most recent Please provide the information in chronological order. (i.e. new to old). If you are not working, provide information such as, unemployed, studying, travelling, retired, imprisoned, etc. Please ensure that there will be no gap in time. Most recent From To City, Province and Country Your Status in the Country (i.e. work permit holder) Occupation, activity and duties Name of company/ facility/ employer 2nd recent From To City, Province and Country Your Status in the Country (i.e. work permit holder) Occupation, activity and duties Name of company/ facility/ employer 3rd recent From To City, Province and Country Your Status in the Country (i.e. work permit holder) Occupation, activity and duties Name of company/ facility/ employer 4th recent From To City, Province and Country Your Status in the Country (i.e. work permit holder) Occupation, activity and duties Name of company/ facility/ employer 5th recent From To City, Province and Country Your Status in the Country (i.e. work permit holder) Occupation, activity and duties Name of company/ facility/ employer 6th recent From To City, Province and Country Your Status in the Country (i.e. work permit holder) Occupation, activity and duties Name of company/ facility/ employer 7th recent From To City, Province and Country Your Status in the Country (i.e. work permit holder) Occupation, activity and duties Name of company/ facility/ employer 8th recent From To City, Province and Country Your Status in the Country (i.e. work permit holder) Occupation, activity and duties Name of company/ facility/ employer 9th recent From To City, Province and Country Your Status in the Country (i.e. work permit holder) Occupation, activity and duties Name of company/ facility/ employer 10th recent From To City, Province and Country Your Status in the Country (i.e. work permit holder) Occupation, activity and duties Name of company/ facility/ employer Additional Information Do you have more than 10 work history? If yes, check the box and provide details below. History of marriage and common-law relationship End date is not required for the current/ongoing marriage or common law relationship Current relationship First Name Middle Name Last Name Date of Birth Type of relationship Married Common Law Relationship (you and your partner have been residing together for a year or more) From (Married or start of relationship) Previous relationship #1 First Name Middle Name Last Name Date of Birth Type of relationship Married Common Law Relationship (you and your partner had resided together for a year or more) From (Married or start of relationship) To (Divorced or end of relationship) Previous relationship #2 First Name Middle Name Last Name Date of Birth Type of relationship Married Common Law Relationship (you and your partner had resided together for a year or more) From (Married or start of relationship) To (Divorced or end of relationship) Previous relationship #3 First Name Middle Name Last Name Date of Birth Type of relationship Married Common Law Relationship (you and your partner had resided together for a year or more) From (Married or start of relationship) To (Divorced or end of relationship) Previous relationship #4 First Name Middle Name Last Name Date of Birth Type of relationship Married Common Law Relationship (you and your partner had resided together for a year or more) From (Married or start of relationship) To (Divorced or end of relationship) Previous relationship #5 First Name Middle Name Last Name Date of Birth Type of relationship Married Common Law Relationship (you and your partner had resided together for a year or more) From (Married or start of relationship) To (Divorced or end of relationship) Additional Information If you have more than 5 relationship history to provide, check the box and provide details below Relatives in Canada I have a relative or relatives who are permanent resident or citizen of Canada Relative in Canada #1 First Name Middle Name Last Name This is my.. Uncle Aunt Brother Sister Brother in law Sister in law Son Daughter Son in law Daughter in law Mother Father Mother in law Father in law Grandmother Grandfather Grandmother in law Grandfather in law Grandson Granddaughter Niece Nephew Other Date of Birth Place of Birth Current Residential Address Immigration or Visa Status in Canada Citizen Permanent Resident Relative in Canada #2 First Name Middle Name Last Name This is my.. Uncle Aunt Brother Sister Brother in law Sister in law Son Daughter Son in law Daughter in law Mother Father Mother in law Father in law Grandmother Grandfather Grandmother in law Grandfather in law Grandson Granddaughter Niece Nephew Other Date of Birth Place of Birth Current Residential Address Immigration or Visa Status in Canada Citizen Permanent Resident Relative in Canada #3 First Name Middle Name Last Name This is my.. Uncle Aunt Brother Sister Brother in law Sister in law Son Daughter Son in law Daughter in law Mother Father Mother in law Father in law Grandmother Grandfather Grandmother in law Grandfather in law Grandson Granddaughter Niece Nephew Other Date of Birth Place of Birth Current Residential Address Immigration or Visa Status in Canada Citizen Permanent Resident Relative in Canada #4 First Name Middle Name Last Name This is my.. Uncle Aunt Brother Sister Brother in law Sister in law Son Daughter Son in law Daughter in law Mother Father Mother in law Father in law Grandmother Grandfather Grandmother in law Grandfather in law Grandson Granddaughter Niece Nephew Other Date of Birth Place of Birth Current Residential Address Immigration or Visa Status in Canada Citizen Permanent Resident Relative in Canada #5 First Name Middle Name Last Name This is my.. Uncle Aunt Brother Sister Brother in law Sister in law Son Daughter Son in law Daughter in law Mother Father Mother in law Father in law Grandmother Grandfather Grandmother in law Grandfather in law Grandson Granddaughter Niece Nephew Other Date of Birth Place of Birth Current Residential Address Immigration or Visa Status in Canada Citizen Permanent Resident Additional Information If you have more than 5 Canadian relative(s), check the box and provide information below During the past 5 years, have you stayed in any country other than your country of citizenship or your current country of residence for more than six months? Yes I have #1 From (YYYY, MM, DD) To (YYYY, MM, DD) City Country Reason of Stay Your Visa Status in the Country Where You Stayed #2 From (YYYY, MM, DD) To (YYYY, MM, DD) City Country Reason of Stay Your Visa Status in the Country Where You Stayed #3 From (YYYY, MM, DD) To (YYYY, MM, DD) City Country Reason of Stay Your Visa Status in the Country Where You Stayed #4 From (YYYY, MM, DD) To (YYYY, MM, DD) City Country Reason of Stay Your Visa Status in the Country Where You Stayed #5 From (YYYY, MM, DD) To (YYYY, MM, DD) City Country Reason of Stay Your Visa Status in the Country Where You Stayed #6 From (YYYY, MM, DD) To (YYYY, MM, DD) City Country Reason of Stay Your Visa Status in the Country Where You Stayed #7 From (YYYY, MM, DD) To (YYYY, MM, DD) City Country Reason of Stay #8 From (YYYY, MM, DD) To (YYYY, MM, DD) City Country Reason of Stay Your Visa Status in the Country Where You Stayed #9 From (YYYY, MM, DD) To (YYYY, MM, DD) City Country Reason of Stay Your Visa Status in the Country Where You Stayed #10 From (YYYY, MM, DD) To (YYYY, MM, DD) City Country Reason of Stay Your Visa Status in the Country Where You Stayed Additional Information If you have more information to provide, check the box and provide details below List of your international travel history of past 10 years Start with the most recent/current information Most Recent From (YYYY, MM, DD) To (YYYY, MM, DD) City Country Purpose of Travel 2nd Recent From (YYYY, MM, DD) To (YYYY, MM, DD) City Country Purpose of Travel 3rd Recent From (YYYY, MM, DD) To (YYYY, MM, DD) City Country Purpose of Travel #4 From (YYYY, MM, DD) To (YYYY, MM, DD) City Country Purpose of Travel #5 From (YYYY, MM, DD) To (YYYY, MM, DD) City Country Purpose of Travel #6 From (YYYY, MM, DD) To (YYYY, MM, DD) City Country Purpose of Travel #7 From (YYYY, MM, DD) To (YYYY, MM, DD) City Country Purpose of Travel #8 From (YYYY, MM, DD) To (YYYY, MM, DD) City Country Purpose of Travel #9 From (YYYY, MM, DD) To (YYYY, MM, DD) City Country Purpose of Travel #10 From (YYYY, MM, DD) To (YYYY, MM, DD) City Country Purpose of Travel #11 From (YYYY, MM, DD) To (YYYY, MM, DD) City Country Purpose of Travel #12 From (YYYY, MM, DD) To (YYYY, MM, DD) City Country Purpose of Travel #13 From (YYYY, MM, DD) To (YYYY, MM, DD) City Country Purpose of Travel #14 From (YYYY, MM, DD) To (YYYY, MM, DD) City Country Purpose of Travel #15 From (YYYY, MM, DD) To (YYYY, MM, DD) City Country Purpose of Travel Additional Travel Information If you have more travel information to provide, check the box and provide details below History of your residential address of the past 10 years or since the age of 18, whichever is most recent Please provide the information in chronological order and ensure that there is no gap in time. Previous Address #1 From (YYYY, MM, DD) To (YYYY, MM, DD) Address Postal Code Country Previous Address #2 From (YYYY, MM, DD) To (YYYY, MM, DD) Address Postal Code Country Previous Address #3 From (YYYY, MM, DD) To (YYYY, MM, DD) Address Postal Code Country Previous Address #4 From (YYYY, MM, DD) To (YYYY, MM, DD) Address Postal Code Country Previous Address #5 From (YYYY, MM, DD) To (YYYY, MM, DD) Address Postal Code Country Previous Address #6 From (YYYY, MM, DD) To (YYYY, MM, DD) Address Postal Code Country Previous Address #7 From (YYYY, MM, DD) To (YYYY, MM, DD) Address Postal Code Country Previous Address #8 From (YYYY, MM, DD) To (YYYY, MM, DD) Address Postal Code Country Previous Address #9 From (YYYY, MM, DD) To (YYYY, MM, DD) Address Postal Code Country Previous Address #10 From (YYYY, MM, DD) To (YYYY, MM, DD) Address Postal Code Country Additional Address Information If you have more address history to provide, check the box and provide details below Military and/or Paramilitary Service History Most Recent From (YYYY, MM, DD) To (YYYY, MM, DD) Location/ Place where stationed City and (if applicable) Province Country 2nd Recent From (YYYY, MM, DD) To (YYYY, MM, DD) Location/ Place where stationed City and (if applicable) Province Country 3rd Recent From (YYYY, MM, DD) To (YYYY, MM, DD) Location/ Place where stationed City and (if applicable) Province Country 4th Recent From (YYYY, MM, DD) To (YYYY, MM, DD) Location/ Place where stationed City and (if applicable) Province Country 5th Recent From (YYYY, MM, DD) To (YYYY, MM, DD) Location/ Place where stationed City and (if applicable) Province Country Additional Information If you have more military or paramilitary history to provide, check the box and provide details below Membership or Association with Organisations Most Recent From (YYYY, MM, DD) I am currently a member of this organisation. To (YYYY, MM, DD) Name of Organisation Type of Organisation Your Activities within Organisation Your Position within Organisation City and Country 2nd Recent From (YYYY, MM, DD) To (YYYY, MM, DD) Name of Organisation Type of Organisation Your Activities within Organisation Your Position within Organisation City and Country 3rd Recent From (YYYY, MM, DD) To (YYYY, MM, DD) Name of Organisation Type of Organisation Your Activities within Organisation Your Position within Organisation City and Country Additional Membership or Association Information If you have more Membership or Association history to provide, check the box and provide details below Government Positions Most Recent From (YYYY, MM, DD) I am currently a member of this government To (YYYY, MM, DD) Country and Jurisdiction (e.g. national, regional, municipal) Department/ Branch Your Activities Within This Government Your Position Within This Government 2nd Recent From (YYYY, MM, DD) To (YYYY, MM, DD) Country and Jurisdiction (e.g. national, regional, municipal) Department/ Branch Your Activities Within This Government Your Position Within This Government 3rd Recent From (YYYY, MM, DD) To (YYYY, MM, DD) Country and Jurisdiction (e.g. national, regional, municipal) Department/ Branch Your Activities Within This Government Your Position Within This Government Additional Information If you have more history to provide, check the box and provide details below Language Ability I have a language test result issued within the last 2 years. English Language Test IELTS (General) test CELPIP (General) test Date of the exam (YYYY, MM, DD) Date of the result issued (YYYY, MM, DD) Your Exam Number(s) (i.e. Pin, Report Form Number) Listening Score Reading Score Writing Score Speaking Score French Language Test TEF test Date of the exam (YYYY, MM, DD) Date of the result issued (YYYY, MM, DD) Your Exam Number(s) (i.e. Pin, Report Form Number) Listening Score Reading Score Writing Score Speaking Score Attestation Information I have provided on this form is accurate and up to date. Through the application process, I will be able to prove some or all of my statements with supporting documents. I understand that providing inaccurate information may result in refusal or a five-year ban of any Canadian visa or status application.} Send Δ Share this:TwitterFacebookLike this:Like Loading...