CONTACT AND FAMILY GENERAL INFORMATION

QUESTIONS:

Main applicant Second applicant Child

First Name:

Last Name:

Sex:

Your date of birth:

(MM/DD/YYYY):

Your country and city/town

of birth:

Your current marital status:

(single, married, separated, divorced,
common-law relationship, conjugal
relationship, other)

Is your wife Canadian

When did you get married

How many children do you

have?
What is their marital status
and age?
(These include those that whether or
not they are natural, adopted, from
previous marriages/relationships
regardless whether they live with you
or not or whether or not you have
legal custody of them).
 Main applicant Second applicant

Do you or your spouse or

common-law partner (if they
will come with you to Canada)
have at least one brother or
sister living in Canada who is
a citizen or permanent
resident?
(18 years or older)
(If you answered “YES” please provide
details including their city and province of
residence and their status)

Have you or your family

members already submitted
an Express Entry profile to the
government of Canada within
the past 12 months?
(If you answered “YES” please provide
details)

Do you or your family

members have a Close Friend
living in the province of
Manitoba who is 18 years or
older?
(If you answered “YES” please provide
details)

Do you have multiple

citizenship, if yes please state
them
(list all countries of citizenship):

Do you have a valid passport

or travel document?

Have you lived in any country

excluding the country of your
residence for more than six
months?

ADMISSIBILITY AND IMMIGRATION COMPLIANCE

QUESTIONS:
Main applicant Second applicant Child

Have you previously applied to

enter or remain in Canada?
(If so, provide details).
Have you ever been refused to
enter Canada?
(If you answered “YES” please provide
refusal details and a copy of your refusal
letter in a separate file).

Do you have any physical or

mental disorder , HIV, Cancer,
diabetes

Do you have a criminal record

Did you serve in the military?

(including non-obligatory national service,
reserve or volunteer units)

EDUCATION - RELATED QUESTIONS:

What is your level of education?

(Please select ALL that apply)

None, or less than secondary (high school)

A secondary diploma (high school graduation)

One-year program at a university, college, trade or technical school, or another

institute

The two-year program at a university, college, trade or technical school, or

another institute

Bachelor's degree (three or more year program at a university, college, trade or

technical school, or another institute)

Two or more certificates, diplomas or degrees. One must be for a program of

three or more years

Master's degree, or professional degree needed to practice in a licensed

profession

Doctoral level university degree (Ph.D)

Have you earned a Canadian degree, diploma or certificate? (NO/YES).

1. Do you have a certificate of qualification from a Canadian province, territory or

federal body? (NO/YES)
(If yes, please provide details)

2. What is your Native Language/Mother Tongue?

3. do you speak English and French

(Please provide details)

YOUR WORK HISTORY

1. have you worked in the past 7 years

2.what is your occupation?

4. Do you have a resume?

6. Do you own a business? If so What is the net value of your business?

8. What is your personal net worth?

9. Do you have any unsatisfied debts, loans?

(If so, please elaborate and provide all relevant details) .