Form - Immigration Questions

Applicant - Immigration questions

Any visia to Canada you need to provide specific disclosure and information

Client File #

Date of Birth

City of Birth

Name

First

Last

Passport number

Issue date

Expiration date

UCI

What you'll do in Canada

Explain why this trip is important; propose dates for your travel. explain what ties you have to your country of residence

1.Have you had a Canadian visa in last 10 years

هل حصلت على فيزا لكندا اخر عشرة سنوات

2.Have you used another name in the past

هل استخدمت اسم اخر

3.were you diagnosed with tuberculosis?

هل اصابك مرض الدرن

4.have you meet anyone with tuberculosis

هل اجتمعت مع شخص معه مرض الدرن

5.Are you currently receiving dialysis treatment

هل تستخدم اجهزة غسل الكلي

6.Have you had a drug or alcohol addiction

هل لديك ادمان على المخدرات او الخمور

7.Have you had a mental health condition

هل لديك امراض عقلية

8.Have you ever been diagnosed with syphilis

هل اصبت بمرض السفلس

9.Did you get visa refusal, removeal order?

هل تم رفض طلب لفيزا او امر بالخروج من دولة

10.Did ever serve in military, militia, civil defense

(هل حملت السلاح مع اي جهة (لا يشمل الخدمة الالزامية

11.Any criminal history or courts ?

هل لديك سجل اجرامي او محاكم

if any is yes, explain

اذا جاوبت اي سؤال بنعم، اشرح هنا

If you are human, leave this field blank.

Form – Immigration Questions