Supplementary Application Form

For Temporary Resident Visa and Study/Work Permit Applications

To be completed by PRINCIPAL APPLICANT (regardless of age)
Applications without this form will be returned unprocessed.

1-Are you applying for a multiple entry visa? Yes No

If yes, why? _________________________________________________________________________________________________
2-Are you travelling with anyone else other than your family members mentioned in your Temporary Resident Visa
Application Form? Yes No If yes, please complete the following:
Full Name: ________________________________________ Relationship: ___________________________________
Full Name: ________________________________________ Relationship: ___________________________________
Full Name: ________________________________________ Relationship: ___________________________________
3-What is the main purpose of your visit to Canada? (Please tick one (1) or more)
Visiting Family Visiting Friends Business Tourism Training Short-term Studies/ESL
Study(Permit) Work (Permit) Other | Specify: ____________________________________
4-Are you staying in a hotel/hostel/B&B? Yes No If yes, please provide details:
Name of Hotel/Hostel/B&B: ____________________________________________________ Length of Stay: ____________ days
Address in Canada: ________________________________________________________________________________________
Telephone: ____________________________________________________________ Fax: _______________________________
5-Are you visiting a relative(s) in Canada? Yes No If yes, please provide details:
Full Name: ______________________________________________ Date of Birth (dd/mm/yyyy): _________________________
Relationship: __________________________________ Address in Canada: ___________________________________________
Is your relative: Studying OR Working? Where? ___________________________________________________________
6-Are you visiting a friend(s) in Canada? Yes No If yes, please provide details as follows:
Briefly state when and where you met: ________________________________________________________________________
Full Name: _______________________________________________ Date of Birth (dd/mm/yyyy): ________________________
Address in Canada: _________________________________________________________________________________________
Is your friend: Studying OR Working? Where? ____________________________________________________________
7-Have you or your close family members ever applied to immigrate to Canada? Yes No
If yes, please provide details: __________________________________________________________________________________
___________________________________________________________________________________________________________
8-If you are not visiting any relative(s)/friend(s), please state which cities in Canada you plan to visit:
City: ____________________ Number of days: _________ City: ____________________ Number of days: _________
City: ____________________ Number of days: _________ City: ____________________ Number of days: _________
9-Who will be responsible for your expenses for this visit to Canada?
Yourself/parents Your employer Your host organisation/family Other | Specify __________________________
10-If you are employed, please indicate what is the main activity of the business/organisation (i.e. construction, oil & gas,
mining, etc.) Be specific. ____________________________________________________________________________________
11-If you are going to Canada on business, indicate the type of business of your host organisation. Be specific.
_________________________________________________________________________________________________________
12-List the countries you visited in the last five (5) years.
Country: __________________ Country: __________________ Country: __________________ Country: ___________________
Country: __________________ Country: __________________ Country: __________________ Country: ___________________
13-Have you ever been refused any kind of visa to any country? Yes No
If yes, please provide details: ________________________________________________________________________________

Mosco/Supp Form/Oct 2010