Refugee Application

Personal Information

Name

Surname/Last name *

Middle Name

Given name/First name

Gender *

Height (Feet and inches) *

Eye colour *

UCI (Unique Client Identifier), if known

Contact information

Address *

City *

State / Province

Postal code / Zip Code

Country *

Email *

Phone Number *

What is your native language or mother tongue? *

Do you speak any other languages? *

What language do you want us to use during your interview? *

What language do you want us to use to contact you? *

Travel document of the applicant

Have you ever had a passport? *

What's the nationality on your passport? *

What's the passport number? *

When was the passport issued? *

Date of expiry of the passport? *

Where is the original copy of this document?

Have you ever had another type of travel document?

Nationality

Country or Territory where you were born *

City or town where you were born *

Countries or territories of citizenship

Country/territory of issue *

How did you become a citizen? *

Date you became a citizen of this country or territory *

Do you have a valid national identity document? *

Country or territory that issued this document *

Document number *

Date of issue *

Expiry date *

Where is the original copy of this document? *

Family information - Marital status

What is your current marital status? *

Date of marriage or common-law relationship started

Current spouse or common-law partner

Surname/last name

Given name/first name

Date of birth

Country or territory of birth *

Does your spouse or partner live with you?

Present address of spouse

Address line 1

Address line 2

City

State / Province

Postal code / Zip Code

Country

Have you been married or in a common-law relationship before?

Family information - Children

Do you have any children (biological, adopted or step children) who are not already included in this claim? *

Children

Surname/last name *

Givename/first name

Date of birth *

Relationship *

Country or territory of birth *

Does the child live with you? *

If No, else leave empty

Address line 1

Address line 2

City *

State / Province

Postal code / Zip Code

Country

Remove Item

Surname/last name *

Givename/first name

Date of birth *

Relationship *

Country or territory of birth *

Does the child live with you? *

If No, else leave empty

Address line 1

Address line 2

City *

State / Province

Postal code / Zip Code

Country

Remove Item

Add another

Parents

Guardian

Do you have a guardian because you can't understand the proceedings or you're under 18 years of age? *

Adress *

Travel to Canada

How did you arrive to Canada? *

Were you a crew member? *

Where did you enter Canada? *

When did you most recently enter Canada? *

What is your current status in Canada? *

Route to Canada

How did you travel? *

Departure date you left *

Country/Territory you left from *

City or town you left from *

Date you arrived to Canada *

City or town in Canada *

Education, work and activities

Post secondary

Are you currently studying or have you ever studied at a post-secondary school? *

study programs

Repeater

School or institution name *

Date studies started *

Date studies ended *

Level of study *

Field of study *

Did you get a degree, diploma or certificate after completing this program? *

Country/territory and/or City/town of the school/institution *

Remove Item

School or institution name *

Date studies started *

Date studies ended *

Level of study *

Field of study *

Did you get a degree, diploma or certificate after completing this program? *

Country/territory and/or City/town of the school/institution *

Remove Item

Add another

Work and activities history

Give details of all your employment and activities for the past 10 years

Repeater

Date started *

Date ended (Leave blank if still working here)

Work or activity *

Address (City, Country) *

Job Title *

Company or employer name *

Main duties of the job *

Remove Item

Date started *

Date ended (Leave blank if still working here)

Work or activity *

Address (City, Country) *

Job Title *

Company or employer name *

Main duties of the job *

Remove Item

Add another

Canada and US visas

Are you a lawful permanent resident of the United States(U.S) with a valid green card (alien registration card)? *

Have you held a Canadian visitor via in the past 10 years? *

Do you currently hold a valid U.S nonimmigrant visa? *

Refugee background

Did someone help you come to Canada? *

Do you have any family members or friends in Canada? *

Did someone help you come to Canada? *

Family/Friend details

Surname/Last name *

Given name/First name

Relation to applicant *

Street number and name *

City *

Country *

Postal Code

Remove Item

Surname/Last name *

Given name/First name

Relation to applicant *

Street number and name *

City *

Country *

Postal Code

Remove Item

Add another

Details of this help

Surname/Last name *

Given name/First name

Type of help *

Amount you paid them

Relation to applicant *

Street number and name *

City *

Country *

Postal Code

Remove Item

Surname/Last name *

Given name/First name

Type of help *

Amount you paid them

Relation to applicant *

Street number and name *

City *

Country *

Postal Code

Remove Item

Add another

Upload your passport

Passport upload *

Upload

Drop file here or click to upload

Maximum file size allowed: 250KB

Personal Information

Contact information

Travel document of the applicant

Nationality

Countries or territories of citizenship

Family information - Marital status

Current spouse or common-law partner

Family information - Children

Parents

Guardian

Travel to Canada

Route to Canada

Education, work and activities

Post secondary

study programs

Work and activities history

Give details of all your employment and activities for the past 10 years

Canada and US visas

Refugee background

Upload your passport

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