Your current marital status
Your UCI (if available)
Your Height (in cm)
Color of Your Eyes
Your Native Language/Mother Tongue
Your Former Name
Your Former Name
If you haven't already, please provide documents supporting this name change. Examples include marriage certificate, legal name change certificate etc.
Past Countries of Residence
Past Marital or Common Law History
Document Number (Green Card)
Expiry Date (Green Card)
Post Secondary Education History
Please list all post secondary (after grade 12th or high school) degree, diploma, certificates etc.
Give details of your employment/activity since the age of 18 or during the past 10 years, whichever is more recent, including if you have held any government positions (such as civil servant, judge, police officer, mayor, member of parliament, hospital administrator). Also list any period of unemployment and ensure you leave no time gaps.
Give details of your home address since the age of 18 or during the past 10 years, whichever is more recent. Please ensure you leave no time gaps.
Siblings Details - Brothers and Sisters
Include all brothers and sisters, including half - and step-brothers and sisters.
Do you have children (including step children)?
Children - Sons and Daughters
Include all sons and daughters, including all adopted and step children regardless of age and place of residence
Please provide details and the name of the family member (if applicable)
Please provide details
Please provide details (Incident, charges and conviction etc.)
Organizations/Political Party - give the following details
Provide details - ill treatment of prisoners or civilians, looting or desecration of religious buildings
Provide details - government positions
Do not use abbreviations
Since the age of 18 or during the past 10 years, whichever is more recent, have you travelled to any country or territory other than the country of your citizenship or your current country of residence?
Citizenship and Immigration Canada (CIC), or an organization at CIC' request, may want to contact you in the future to ask you about any services you received from CIC prior to the application process (such as participation in an information forum), during the application process (including the application process itself as well as orientation or accreditation services), and services received after arriving in Canada (including settlement, integration and citizenship). CIC will use this information , along with the information provided by other individuals, for research, performance measurement or evaluation purposes. CIC will not use this information to make any decisions about you personally .
Any additional information/explanation (optional)