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Personal Information Request Form
Please complete the following form for your assessment
Section 1 – Personal Information
1.8) Do you have dependent children?
Section 2 – Education/Employment
2.3) Highest level of education completed
2.5) Who will sponsor your travel to Canada
Section 3 – English Proficiency
3.1) Do you have a valid English proficiency result? E.g. "IELTS"
If you answered yes to question 3.1, please enter your test scores.
Section 4 – Background Information
4.1) 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?
4.2) Do you have any physical or mental disorder that would require social and/or health services, other than medication, during a stay in Canada?
Section 5 – Background Information
5.1) Have you ever remained beyond the validity of your status, attended school without authorization or worked without authorization in Canada?
5.2) Have you ever been refused a visa or permit, denied entry or ordered to leave Canada or any other country or territory?
5.3) Have you previously applied to enter or remain in Canada?
Section 6 – Background Information
6.1) Have you ever committed, been arrested for, or been charged with or convicted of any criminal offence in any country or territory?
6.3) Did you serve in any military, militia, or civil defense unit or serve in a security organization or police force ( including non obligatory national service, reserve or volunteer units) ?
6.5) 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 achieve a political or religious objective, or which has been associated with criminal activity at any time?
6.6) Have you ever witnessed or participated in the ill treatment of prisoners or civilians, looting or desecration of religious buildings?
6.7) Have you ever held any government positions ( such as civil servant, judge, police officer, mayor, member of parliament, hospital administrator?
International Passport
Education Records
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