REQUEST FOR A REFUGEE PROFILE

REFER TO THE INSTRUCTION GUIDE FOR INFORMATION ON THIS FORM

If you require more space, attach a separate sheet of paper.

FOR CIC USE ONLY

Matching centre file no.

CIC file no. Principal Applicant Id no.

Visa office file no.

A- TYPE OF SPONSORSHIP/CASE YOUR GROUP IS INTERESTED IN (you may select more tan one)

Visa office-referred Urgent protection

B- TYPE OF FAMILY/INDIVIDUAL YOU WISH TO SPONSOR

1. Country of origin

2. Family size and composition

C- INFORMATION ON SPONSORING GROUP

1. Name of group and contact information

2. Group composition

3. Language skills

4. Experience in refugee sponsorship

5. Other pertinent information

D- INFORMATION ON YOUR COMMUNITY

1. Seattlement services avaible in the community

2. Language training avaible (example: English as a second language

3. Other services avaible (specialized services, community services, education, training, health,
medical)

4. Immigrant groups resettled in the community during the last 10 years

5. Population

6. Employment opportunities, labour recruitment needs

7. Community profile information (rural, urban)

The information you provided on this form is collected under the authority of the immigration and
Refugee Protection Act and will be used to maintain a record of application and private
sponsorship undertakings of refugees according to the requirements of the Act. It will be retained
in the Personal Information Bank CIC PPU 008 identified in infosource . It may be shared whit
other organizations in accordance whit the consistent use of information under the Privacy Act.
Under the Privacy Act and the Acces to information Act individuals have the right to protection of
and acces to their personal information. Details on these matters are avaible at infosource.gc.ca
and through the Citezenship and Immigration Call Centre. Infosource is also avaible at Public
Libraries in Canada.