If you answered “Yes” to one or more of these questions, you must explain what happened in the space provided. If you need more space, attach a separate sheet of paper.
For questions 7-12, when answering:
If a question doesn’t apply to you, write “N/A” in the question.
If you need more space, attach a separate sheet of paper.
Important information: Processing will be delayed if you do not account for all periods of time.
Enter the number of years of formal education you have completed at each of the levels indicated.
Provide the details about each secondary and post-secondary educational institution you attended, including the:
If no diploma was issued, write “N/A”. If you need more space, attach a separate sheet of paper.
Start with the most recent information.
If you were working:
If you were not working:
If you were outside your country of nationality, enter your status of the country you were in.
This includes:
If you were not a member of an association or organization, do not write “not applicable”. Instead, enter: “I have never been a member of an organization or association”.
Do not use abbreviations.
Enter “NONE” in the box if you have not been a member of an association or organization.
Include:
Do not use abbreviations.
Authority to disclose personal information
Declaration of applicant
Read all of the statements in all sections carefully. Sign and date in the boxes provided. By signing, you certify that you fully understand the questions asked, and that the information you have provided is complete, truthful, and correct. If you do not sign and date, the application will be returned to you.
Note: The bottom section of Schedule A should not be completed at this time.
This form must be completed by:
Write the personal details for:
Write the personal details for your children. It is very important that you list all of your children (even if they are already permanent residents or citizens of Canada). This includes:
You must answer all questions. If any sections do not apply to you, answer “N/A”.
Write personal details about your:
After carefully reading the statements contained in this section, sign and date the declaration.
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