Current Country or territory of Residence :
Previous Country of Residence:
Country or Territory where applying:
Marital Status
Provide name of your current spouse / Common-law Partner
Provide the following details for your previous Spouse / Common-law relationship:
Languages
Passport
US PR Card
Contact Information
Current Mailing Address
Residential Address
Details of Visit
Indicate how long will you stay :
Name, Address and Relationship of person / institutions I will visit
Education
Employment Details
Give details of your employment for past 10 year including if you have held any government positions such as (Police Officer, Hospital Administrator, Lawyer, Member of Parliament, Mayor, Judge, Civil Servant, Employee of any Security Organization). Do not leave gaps. If retired, not working or studying, please indicate. If your are retired, please provide 10 years before the retirement.
Background Information
You must complete this section if you are 18 years of age or older.
