NOTE: Write N/A if a question does not apply to your situation. (The masculine form is used to simplify the text; the masculine gender includes the feminine).
Personal information : All information provided is confidential and will only be used to determine the program best suited to your profile and your immigration project.
Your name
Your first name
Your middle name(s)
Date of birth
Sex: ManWoman
Country of birth
Country of residence
Passport number
Country of passport issue
Date of issue
Expiry date
Current address
Email address
Cell phone
Home telephone
If you are married, when did you get married?
IF you are in a common-law relationship, when did you start living together?
IF you are married or in a common-law relationship, will your spouse immigrate to Canada with you? YesNo
Do you have children? YesNo
How many children do you have?
IF you have children, please indicate their ages
Indicate whether you have worked/studied in Canada/visited Canada/never been to Canada.
Have you already obtained a work or study permit in Canada? YesNo
IF you have already lived in Canada, indicate when
Enter the total amount of transferable funds legally at your disposal
Do you or your spouse have any family members who are permanent residents or citizens of Canada currently living in Canada? YesNo
If you answered YES to the previous question, please specify the relationship between these family members and you or your spouse, and indicate the name of the city in Canada where they currently live.
If you have taken a French language proficiency test (TEF or SEL), please answer the following questions.
Test date
Test type NoneTEF CanadaTCF Canada
Reading comprehension
Written expression
Oral expression
Listening comprehension
Please provide the following information about your post-secondary studies and ALL the educational institutions you have attended, whether or not you have obtained a diploma.
From:
A:
School name
City/Country
Type of certificate or diploma awarded
Field of study - if no specific field, indicate "general".
Please list your employment history for the last ten (10) years - starting with your current position - and include part-time positions.
Job title
Name of company, employer, school, etc.
Municipal address for CANADIAN employers ONLY
Please list all your international trips in the last ten (10) years.
Purpose of the trip
Visa issued: S/OYesNo
Please read the following statements carefully and answer honestly. Do you, your spouse or dependents :
Have you ever been convicted in a criminal proceeding, in any jurisdiction, or are you currently the subject of such a proceeding? : YesNo
Have you ever made a refugee claim in Canada or applied for a Canadian immigrant or permanent resident visa OR any other type of visa (e.g. temporary resident or visitor)? YesNo
Have you ever been refused refugee status OR any other type of visa (e.g., immigrant, permanent resident, visitor, temporary resident) in Canada or another country? YesNo
Have you ever been refused entry to Canada OR another country, or had a deportation order issued against you? YesNo
Have you taken part in an act of genocide, a war crime, a crime against humanity or the desecration of religious property? YesNo
Have you used or planned to use violence to achieve political, social or religious objectives? YesNo
Have you been a member of a group that is or was involved in organized crime? YesNo
Have you suffered from any serious physical or mental illness or disorder? YesNo
Is there any other information you feel is important to share with CRIC as part of your preliminary assessment? YesNo
Have you already applied to platforms like Arrima or Express Entry? YesNo
Have you ever applied for asylum in Canada or at a Canadian visa office abroad, in one or more other countries, or at the United Nations High Commissioner for Refugees (UNHCR)? If yes, specify country YesNo
Have you ever been refused a visa, permit or entry to a country, or been ordered to leave a country other than Canada? YesNo
Have you ever studied or worked in Canada or the United States? If so, please give as many details as possible. YesNo
Have you ever applied to immigrate or travel to the United States? If your application has been refused, please specify the reason. YesNo
Have you ever been turned down for a study permit in Canada? If yes, specify year. Please enclose a copy of the letter YesNo
Have you ever been refused a work permit in Canada? If yes, please specify the year and send us the letter of refusal. Add any other relevant details. YesNo
Have you ever been refused a visitor's visa to Canada? If yes, please specify the year and send us the letter of refusal. Add any other relevant details. YesNo
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