Questionnaire

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Contact Information

Your
Information

First Name: 
Last/Family Name: 
Gender (sex):
Date Of Birth: 
Country Of Birth: 
Current Citizenship?: 
Home Phone Number: 
Work Phone Number:
Fax Number:
Email Address:

Spouse or Common Law Partner's Information

First Name:
Last/Family Name:
Gender (sex):
Date Of Birth:
Country Of Birth:
Current Citizenship?:
Home Phone Number:
Work Phone Number:
Fax Number:
Email Address:
Children: Number:    Ages:
Have you, your Spouse, or your children ever had any serious medical problems?
Do you or your spouse/common law partner have a criminal record
Do you have close relatives living in Canada?
(check all that apply)



Does your spouse/common law partner
have close relatives living in Canada? (check all that apply)



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Information found in this website is not legal advice. The webpage content should not be used to make any decisions related to an immigration matter. We can provide specific advice to you only after you have contacted us and we have reviewed your individual circumstances.