SUPPLEMENTARY INFORMATION FORM

PLEASE CO MPLET E A LL APPLICABL E Q UES TIO NS. IF ADDITIO NAL SPA CE IS R EQ UIRED, PLEASE USE A
SEPARATE SHEET. FORMS MUST BE COMPLETED IN EITHER ENGLISH OR FRENCH.

15. Have you ever travelled to Canada before? If so, when and how long were you in Canada?

16. Ma rital status

9 single (never married) 9 married 9 commo n-law union 9 widowed 9 separated 9 divorced
17. I am currently
9 Employed 9 Self-employed 9 Unemployed 9 A Student
9 Retired 9 A Housewife 9 A Farmer 9 _____________________

If retired, please indicate date of retirem ent and last emp loyment:

18. Em ploymen t background in past 5 yea rs:

name of employer your position nature of business perio d of emplo yment

employment background of your spouse (if applicable)

name of employer your position nature of business period of employment

19. Do you or your spouse have any close relatives living in Canada?
9 No 9 Yes Please list names, addresses and relationship

V-2.E (09/2006) ...2/

 -2-

VISITOR FAMILY COMPOSITION INFORMATION

PLEASE COMPLETE FOR ALL RELATIVES INDICATED, WHETHER ACCOMPANYING OR NOT:

FIRST NAME & SURNAME OF THE D A T E & P LA C E O F PRESENT ADDRESS P R ES E N T

A P P L IC A N T BIRTH O C C U PA T IO N

CHILDREN (All sons and daughters and their spouses, including adopted and step -children regardless of age and residence):

F IR ST NA M E & SU R NA M E REL AT IO N SH IP D A T E & P LA C E O F PRESENT ADDRESS MARITAL P R ES E N T

BIRTH S T AT U S O C C U PA T IO N

PARENTS, BROTHERS AND SISTERS (Including half and step brothers and sisters):

F IR ST NA M E & SU R NA M E REL AT IO N SH IP D A T E & P LA C E O F PRESENT ADDRESS MARITAL P R ES E N T

BIRTH S T AT U S O C C U PA T IO N

PERSONAL DETAILS OF YOUR SPOUSE:

FIRST NAM E & SURN AM E OF SPOUSE D A T E & P LA C E O F PRESENT ADDRESS P R ES E N T

BIRTH O C C U PA T IO N

PARENTS, BROTHERS AND SISTERS (Including half and step brothers and sisters):

F IR ST NA M E & SU R NA M E REL AT IO N SH IP D A T E & P LA C E O F PRESENT ADDRESS MARITAL P R ES E N T

BIRTH S T AT U S O C C U PA T IO N

If space provided is inadequate, please continue on a separate sheet. All children and brothers/sisters must be declared on this form.
Incomplete information may lead to the refusal of your application.

_____________________________
Signature of the applicant
V-2.E (04/00)