Preferred Language of Communication with Government of Canada
Have you taken a test from a designated testing agency to assess your proficiency in English or French?
Have you ever used any other name (e.g. Nickname, maiden name, alias, etc.)?
Your Former Name
If you haven't already, please provide documents supporting this name change. Examples include marriage certificate, legal name change certificate etc.
During the past five years have you lived in any country other than your country of citizenship or your current country of residence for more than six months?
Past Countries of Residence
Have you previously been married or in a common-law relationship?
Past Marital or Common Law History
Are you a lawful Permanent Resident of the United States with a valid alien registration card (green card)?
Have you come to Canada previously?
Have you had any post secondary education (including university, college or apprenticeship training)?
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.
Do you have siblings - Brothers and Sisters (including half and step siblings)?
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
Within the past two years, have you or a family member ever had tuberculosis of the lungs or been in close contact with a person with tuberculosis?
Do you have any physical or mental disorder that would require social and/or health services, other than medication, during a stay in Canada?
Have you ever remained beyond the validity of your status, attended school without authorization or worked without authorization in Canada?
Have you ever been refused a visa or permit, denied entry or ordered to leave Canada or any other country or territory?
Have you previously applied to enter or remain in Canada?
Have you ever committed, been arrested for, or been charged with or convicted of any criminal offence in any country or territory?
Did you serve in any military, militia, or civil defence unit or serve in a security organization or police force (including non obligatory national service, reserve or volunteer units)?
Are you, or have you ever been a member or associated with any political party, or other group or organization which has engaged in or advocated violence as a means to achieving a political or religious objective, or which has been associated with criminal activity at any time?
Organizations/Political Party - give the following details
Have you ever witnessed or participated in the ill treatment of prisoners or civilians, looting or desecration of religious buildings?
Provide details - ill treatment of prisoners or civilians, looting or desecration of religious buildings
Have you ever held any government positions (such as civil servant, judge, police officer, mayor, member of parliament, hospital administrator)
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 .
Do you consent to be contacted by CIC, or an organization at CIC's request, in the future?