Home
About Us
Services
Contact
Home
About Us
Services
Contact
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
Preferred Language
*
English
French
UCI Number
*
Family Name
*
Given Name
*
Other Name (if any)
Maiden Name, Patrionymic Name or Nickname
Current Province of Residence in Canada?
*
City
*
Sex
*
Male
Female
Other
Date of Birth (YYYY-MM-DD)
*
Place of Birth
*
City and Province
or, Full of
Country of Birth
*
Current Country of Residence
*
If you are living in Canada put 'Canada', if overseas, please the country you are currently residing.
From (YYYY-MM-DD)
*
To (YYYY-MM-DD)
*
Status in the country
*
Citizen
Worker
Student
Visitor
Refugee
Foreign National
Other
Date of your last entry to Canada? (YYYY-MM-DD)
*
This is the date of when you last entered in Canada if you left and re-entered.
Place of your last entry to Canada?
*
If you flew by air, enter the airport where you entered and the city and province where it is located.
Date of your original entry to Canada? (YYYY-MM-DD)
*
This is the date of when you first came to Canada.
Place of when you originally came to Canada.
*
If you flew by air, enter the airport where you entered and the city and province where it is located.
Document Number
*
Document Number of your Work or Study Permit or Visitor Record
Previous countries of residence: during the past five years, have you lived in any country other than your country of citizenship or your current country of residence (indicated above) for more than six months?
*
No
Yes
If yes, please provide the country of where you stayed, duration (complete dates) and your status in the country. You can add multiple entries.
*
FORMAT: Country - YYYY-MM-DD to YYYY-MM-DD - Worker
Marital Status
*
Single/Never Married
Married
Common-law
Conjugal Partner
Widowed
Legally Separated
Divorced
Annulled
Legally Separated means you are still married but are no longer together and not cohabiting anymore. Conjugal Partner means you are in a relationship for a least one year and are financially, socially and physically dependent. Common-law means you have cohabited with your partner for at least one year.
Have you previously been married or in a common-law relationship?
*
Yes
No
If yes, provide the information of your previous partner including full name, date of birth, type of relationship (married or common-law partner) and duration of your relationship.
*
FORMAT: Full Name - YYYY-MM-DD - Married - YYYY-MM-DD to YYYY-MM-DD. E.g. Mary Jones - 1987-01-03 - Married - 2000-06-01 to 2019-07-27.
Phone Number
*
Add the Country Code
Full Address, Include Apartment/Unit Number (if any), House or Building Number, Street Address, City, Province and Postal or ZIp Code and Country
*
E.g. Unit 500, 123 Bathurst Street, North York, Ontario, M2M 1Y1, Canada
Email Address
*
Do you have a valid passport/travel document?
*
Yes
No
Passport/Travel document number
*
Country of issue
*
The issuing country. For example, you are a Philippines citizen and got your passport issued by the Consulate located in Canada, you should put Philippines are the country of issue not Canada.
Issuing Date (YYYY-MM-DD)
*
Expiration Date (YYYY-MM-DD)
*
Do you have a national identity document?
*
If yes, provide information:
National identity document number, Country of Issue, Issue date (YYYY-MM-DD), Expiry date (YYYY-MM-DD).
Highest level of education
*
If you have a Bachelor's Degree, put Bachelor's Degree,.
Number of years of education in total:
*
Include all the years you attended primary/elementary, secondary or high school, college, university, post graduate school and other vocational or technical school years.
Current Occupation
*
Current Employment Information
*
Name of Employer; Complete Address of Employer; Job Title; Brief Description of duties [E.g. ABC Corp.; 123 Street Ave., Toronto, ON, Canada , 1A2 3B4, Accountant; Process payroll and tax filings etc.]
Employment from the last 10 years
*
Provide Full Duration FROM: (YYYY-MM-DD), TO (YYYY-MM-DD), Job Title/Position; Full Company Name; City/Town; Country, Province. [E.g. 2016-02-17 to 2024-09-13; Accountant; ABC Corp.; Toronto; Canada; ON]
Are you able to communicate in English or French
*
Yes
No
In which language are you most at ease?
*
English
French
If you have taken a test from a designated testing agency to assess your English or French skills, provide information:
Provide the following: Type of Test you took (e.g. CELPIP General), Date of When you taken the test (YYYY-MM-DD), Date of signing or when you got the result (YYYY-MM-DD), Registration Number and /PIN number, and scores, Listening, Speaking, Writing and Reading.
Full Name of Spouse (If married or in common-law relationship)
*
Current Full Address of Spouse
Date of Birth of Spouse or Partner (YYYY-MM-DD)
Email Address of Spouse or Partner
Mother's Full Name
*
Mother's Maiden Name
*
This is her last name before she got married.
Mother's Date of Birth (YYYY-MM-DD)
*
Mother's Place of Birth
*
Current Full Address of Mother
*
Mother's Email Address (if any)
If mother is deceased, provide the Date of Death and the city, province and country of where they passed away
Father's Full Name
*
Father's Date of Birth (YYYY-MM-DD)
*
Current Full Address of Father
*
Father's Place of Birth
*
Father's Email Address (if any)
If father is deceased, provide the Date of Death and the city, province and country of where they passed away
Children's Information of you have any
*
Provide their Full name/s, Relationship to you -Date of Birth (YYYY-MM-DD), Date of Death - if applicable (YYYY-MM-DD), Country or Territory of Birth, Marital Status, Email Address and Full Address. (E.g. Anita Jones - Daughter - 2003-03-20 - Canada - Single - anitajones@gmail.com - Unit 500, 123 Bathurst Street, North York, Ontario, M2M 1Y1, Canada) If you have more than one child, add all information of each child.
Sibling/s' information of you have any
*
Provide their Full name/s, Relationship to you -Date of Birth (YYYY-MM-DD), Date of Death - if applicable (YYYY-MM-DD), Country or Territory of Birth, Marital Status, Email Address and Full Address. (E.g. Anita Jones - Sister- 2003-03-20 - Canada - Single - anitajones@gmail.com - Unit 500, 123 Bathurst Street, North York, Ontario, M2M 1Y1, Canada). Add all information of each sibling.
Have you or, any of your family members listed in this application, ever been convicted of a crime or offence in Canada for which a pardon has not been granted under the Criminal Records Act of Canada?
*
No
Yes
Have you or, any of your family members listed in this application, ever been been convicted of or are currently charged with, on trial for, or party to a crime or offence, or subject of any criminal proceedings in any other country or territory?
*
No
Yes
Have you or, any of your family members listed in this application, ever been made previous claims for refugee protection in Canada or at a Canadian visa office abroad, in any other country(ies) or territory(ies), or with the United Nations High Commissioner for Refugees (UNHCR)?
*
No
Yes
Have you or, any of your family members listed in this application, ever been been REFUSED refugee status, an immigrant or permanent resident visa (including a Certificat de Sélection du Québec [CSQ] or application to the Provincial Nominee Program) or a visitor or temporary resident visa, for Canada or any other country or territory?
*
No
Yes
IF YOU HAVE PREVIOUS REFUSAL IN CANADA OR ANY OTHER COUNTRIES, PLEASE PROVIDE DATE, LOCATION AND REASON OF REFUSAL
*
Have you or, any of your family members listed in this application, ever been been refused admission to, or ordered to leave, Canada or any other country or territory?
*
No
Yes
Have you or, any of your family members listed in this application, ever been been involved in an act of genocide, in a war crime or in the commission of a crime against humanity?
*
No
Yes
Have you or, any of your family members listed in this application, ever been used, planned or advocated the use of armed struggle or violence to reach political, religious or social objectives?
*
No
Yes
Have you or, any of your family members listed in this application, ever been been associated with a group that used, uses, or advocated or advocates the use of armed struggle or violence to reach political, religious or social objectives?
*
No
Yes
Have you or, any of your family members listed in this application, ever been been a member of an organization that is or was engaged in an activity that is part of a pattern of criminal activity?
*
No
Yes
Have you or, any of your family members listed in this application, ever been been detained, incarcerated or put in jail?
*
No
Yes
Have you or, any of your family members listed in this application, ever been had any serious disease or physical or mental disorder?
*
No
Yes
If you answered yes to any of the questions above, please provide information
*
Provide details on all membership and association with organizations
Duration from (YYYY-MM-DD) to (YYYY-MM-DD), Name of Organization, Type of Organization, Activities and/or positions held within organization, City and country/territory
Provide all details on Government positions
Duration from (YYYY-MM-DD) to (YYYY-MM-DD), Country/territory and level of jurisdiction (national, regional, municipal), Department/branch, Activity and/or positions held
Details on Military and Paramilitary service
Duration from (YYYY-MM-DD) to (YYYY-MM-DD), Branch of service, unit numbers and names of your commanding officers, Rank(s), Dates and places of any active combat, Reason for end of service
Submit
