Professional Documents
Culture Documents
Application Summary
Group information
Do you want to apply for more than 1 person at the same time? No
Representative
Gender Male
Select the country code that matches the one on your passport BGD (Bangladesh)
Are you a lawful permanent resident of the United States with a valid Green Card
No
(alien registration card)?
From 1996-02-15
List your current country or territory of residence, then add all other countries or territories where you've lived for the past five
years, for more than 6 months.
Country/territory Bangladesh
Status Citizen
From 1986-02-15
Do we already have your fingerprints and photo (biometrics), and are they still
No
valid?
Finances
How much money do you have for your stay in Canada? (In Canadian dollars -
1500
CAD)
Give details of each program you have studied and are currently studying. SYLHET GOVT COLLEGE
From 2002-05
To 2004-06
Give details of each program you have studied and are currently studying. SYLHET COMMERCE COLLEGE
From 2004-07
To 2006-05
Give details of each program you have studied and are currently studying. SCHOLARSHOME SYLHET
From 2000-01
To 2002-03
Work/activities history
Military/police history
Did you serve in any military, militia, civil defence unit, security organization or
No
police force (including non-obligatory service, reserve or voluntary units)?
Give details of all your employment and activities since the age of 18.
From 2009-12
To 2014-07
From 2016-04
Ongoing
From 2017-07
Ongoing
From 2006-06
To 2009-11
From 2014-08
Ongoing
Travel history
During the past 5 years have you travelled to a country or territory other than the
Yes
one where you're a citizen or where you live now?
From 2023-11
To 2023-12
Country/territory Qatar
From 2023-10
To 2023-11
From 2023-05
To 2023-06
Country/territory India
From 2017-11
To 2017-12
Country/territory Malaysia
Have you ever stayed in Canada beyond the validity of your status, attended
school in Canada without authorization, or worked without authorization in No
Canada?
Have you ever been refused a visa or permit, denied entry to, or ordered to leave
No
any country or territory?
Have you ever committed any crime in any country or territory (this includes
No
driving under the influence of alcohol or drugs)?
Have you ever been arrested for any criminal offence in any country or territory
No
(this includes driving under the influence of alcohol or drugs)?
Have you ever been charged for any criminal offence in any country or territory
No
(this includes driving under the influence of alcohol or drugs)?
Have you ever been convicted for any criminal offence in any country or territory
No
(this includes driving under the influence of alcohol or drugs)?
Are you or have you ever been a member associated with any political party, or
other group or organization which has engaged in or advanced violence as a
No
means to achieving a political or religious objective, or which has been
associated with criminal activity at any time?
Have you had a medical exam performed by an IRCC authorized panel physician
No
(doctor) within the last 12 months?
In the last 5 years, have you been in close contact with a person with
No
tuberculosis?
Have you had a drug or alcohol addiction causing you to be a threat to yourself or
No
others, or to be hospitalized?
Have you had a mental health condition causing you to be a threat to yourself or
No
others, or to be hospitalized?
Family information
Children
Relationship Son
Relationship Son
Relationship Father
Relationship Mother
Fees
Total CAN$185
I consent to the release to Citizenship and Immigration Canada (CIC) and Canada Border Services Agency (CBSA) of all records and information for the
purpose of processing my request that any government authority, including police, judicial and state authorities in all countries in which I have lived may
possess about me. This information will be used to evaluate my suitability for admission to Canada or to remain in Canada pursuant to Canadian
legislation.
I declare that I have answered all questions in this application fully and truthfully.
Privacy Notice
Personal information provided on this form is collected and will be used, disclosed, and retained by Immigration, Refugees and Citizenship Canada
(IRCC) under the authority of the Immigration and Refugee Protection Act (IRPA). The personal information provided will be used for the purpose of
processing applications. The personal information provided may be disclosed to other federal government institutions and third parties including law
enforcement bodies, provincial/territorial governments and/or foreign governments for the purpose of validating identity, eligibility and admissibility.
The personal information collected on an application, and other information collected in support of an application, may be used for advanced analytics,
automation, and other technologies to support processing of applications and decision making, including your application. Personal information,
including from advanced analytics, automation, and other technologies, may also be used for purposes including research, statistics, program and
policy evaluation, internal audit, compliance, risk management, strategy development and reporting.
Where biometrics are provided in support of an application, the fingerprints collected will be stored and shared with the RCMP. The fingerprint record
may also be disclosed to law enforcement agencies in Canada in accordance with subsection 13.11(1) of the Immigration and Refugee Protection
Regulations. The information may be used to establish or verify the identity of a person in order to prevent, investigate, or prosecute an offence under
any law of Canada or a Province. This information may also be used to establish or verify the identity of an individual whose identity cannot reasonably
be otherwise established or verified because of physical or mental condition. Canada may also share immigration information related to biometric
records with foreign governments with whom Canada has an agreement or arrangement.
Failure to complete the form in full may result in a delay or the application not being processed. The Privacy Act gives individuals the right of access to,
protection, and correction of their personal information. Further details are available in Info Source. If you are not satisfied with the manner in which
IRCC handles your personal information, you may exercise your right to file a complaint to the Office of the Privacy Commissioner of Canada. The
collection, use, disclosure and retention of your personal information is further described in IRCC's Personal Information Bank – IRCC PPU 068.