PERSONAL INFORMATION FORM

1

1. Principal Applicant - Personal Information Family Name: (As written in Passport) Given Name/s: Date of Birth: (yyyy/mm/dd)

Given Name/s: Date of Birth: (yyyy/mm/dd)

Email: Phone No.: Fax No.:

Current Country of Residence: Complete Current Residential Address (if different from Mailing Address above)

Family Name

Given Name/s

Relationship

Date of Birth

Current Country of Residence

3. Relatives Living in Canada

Name

Relationship

Town/City, Province

Phone No.:

Status

Family Name

Country of Nationality: Mailing Address:

Passport Number & Issuing Authority Date Issued Expiry Place Issued Place of Birth

Marital Status: Previous Marriage /Relationship, if any:

2. Family Members (Spouse/Common Law/Partner and Children)

(Spouse/Common Law/Partner)

PERSONAL INFORMATION FORM

4. Language Skills Fluent Good With Some Difficulties Very Limited None

English

French

Do you have IELTS?

Yes No Date & Place Taken Score Breakdown Total Band Score

Speaking Listening Reading Writing

5. Work Experience (last 10 years)

Title/Position Company Location From To

6. Formal Education and Training

Do you have an Educational Credential Assessment (ECA)?

Yes No ECA result Date Issued

Do you have an Educational Credential Assessment (ECA)?

Yes No ECA result Date Issued

School / College / University Course/Program Degree/Level & GPA From To

School / College / University Course/Program Degree/Level & GPA From To

7. Spouse/Common Law/Partner’s Formal Education and Training

2

PERSONAL INFORMATION FORM

Fluent

Good

With Some Difficulties

Very Limited

None

English

French

Do you have IELTS?

Yes No Date & Place Taken Score Breakdown Total Band Score

Speaking Listening Reading Writing

Title/Position

Company

Location

From

To

8. Purpose of Application/Previous Travels to Canada a. What is the purpose of your application to Canada?

Study Business Work Visit Others

Course:

b. Have you been refused refugee status, an immigrant or permanent resident visa or visitor visa to Canada or any other country? When?

Yes No

c. Have you been to Canada before?

Yes No When Where Purpose

____________________________ ____________________________ ____________________

Printed Name Signature Date

b. Spouse/Common Law/Partner’s Language Skills:

c. Spouse/Common Law/Partner’s Work Experience: