Visa Application Summary

Group Information

Do you want to apply for more than 1 person at the same time?

Visa Application

I want to apply for a: Why do you need a visa? Tell us more about what you'll do in Canada. Include dates. When will you enter Canada? When will you leave Canada?

Representative

Are you applying on behalf of someone else?

Travel Document of the Applicant

Surname or last name: Given name or first name: Date of birth: Gender:

Travel Document Information

What document are you travelling with? Passport number: Date of expiry of the passport:

Additional Information

Email address: Telephone number:

Documents

Letter of invitation (PDF): Scan Passport (PDF):

Fees

Visitor visa Fee: Biometrics Fee:

Consent and Declaration

Do you consent to be contacted by CIC or an organization at CIC's request in the future? I declare that I have answered all questions in this application fully and truthfully.

Travel Document Information

Travel Document Information of the Applicant

What document are you travelling with? What kind of passport? Select the country code that matches the one on your passport: What's the nationality on your passport? What's your passport or travel document number? Confirm your passport or travel document number When was the passport issued? Date of expiry of the passport: Are you a lawful permanent resident of the United States with a valid Green Card (alien registration card)? Have you held a Canadian visitor visa in the past 10 years? Do you currently hold a valid U.S. nonimmigrant visa? Nonimmigrant visa number: Expiry date of the U.S. nonimmigrant visa: Are you using a different passport for this application than the one you used to get your U.S. nonimmigrant visa? Are you travelling to Canada by air?

Citizenship and Places Where You Have Lived

Country or territory where you were born: City or town where you were born: Are you a citizen of more than one country or territory? Which country or territory are you a citizen of? I am a citizen of this country or territory since:

National Identity Document of the Applicant

Do you have a valid national identity document? Document number: Confirm your document number: Date of issue of national identity document: Select the country or territory that issued this document:

Travel Document Information of the Applicant

What document are you travelling with?

What kind of passport?

Select the country code that matches the one on your passport

Passport or travel document number

Date of expiry of the passport

Are you a lawful permanent resident of the United States with a valid Green Card (alien registration card)?

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

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

Nonimmigrant visa number

Expiry date of U.S. nonimmigrant visa

Are you using a different passport for this application than the one you used to get your U.S. nonimmigrant visa?

Are you travelling to Canada by air?

Citizenship and Places Where the Applicant Has Lived

Country or territory where you were born

City or town where you were born

Are you a citizen of more than one country or territory?

Which country or territory are you a citizen of?

I am a citizen of this country or territory since birth

National Identity Document of the Applicant

Do you have a valid national identity document?

Document number

Date of issue

Select the country or territory that issued this document

Contact Information of the Applicant

Is your mailing address the same as your residential address?

Mailing Address

Current country or territory of residence

Status

From

Invitation

Who is inviting you?

Relationship to you

Mailing Address

Telephone number

Email address

Has someone else also invited you?

Finances

How much money do you have for your stay in Canada? (In Canadian dollars - CAD)

Is someone else giving you money for your stay in Canada?

Information About Education, Work, and Other Activities

Post-secondary Education History

Have you ever studied at a post-secondary school (university, college or vocational school)? You don't need to have completed a degree or diploma.

Work/Activities History

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

From

Work/Activity

Address

Military/Police History

Did you serve in any military, militia, civil defence unit, security organization or police force (including non-obligatory service, reserve or voluntary units)?

Travel History

During the past 5 years have you travelled to a country or territory other than the one where you're a citizen or where you live now?

Travel Details

India

From

To

Location/Place where stationed

Purpose of travel

Maldives

From

To

Location/Place where stationed

Purpose of travel

United States of America

From

To

Location/Place where stationed

Purpose of travel

United States of America (Second Visit)

From

To

Location/Place where stationed

Purpose of travel

Criminality and Security

Have you ever committed any crime in any country or territory (this includes driving under the influence of alcohol or drugs)?

Have you ever been arrested for any criminal offence in any country or territory (this includes driving under the influence of alcohol or drugs)?

Have you ever been charged for any criminal offence in any country or territory (this includes driving under the influence of alcohol or drugs)?

Have you ever been convicted for any criminal offence in any country or territory (this includes driving under the influence of alcohol or drugs)?

Are you or have you ever been a member associated with any political party, or other group or organization which has engaged in or advanced violence as a means to achieving a political or religious objective, or which has been associated with criminal activity at any time?

Have you ever witnessed or participated in the ill treatment of prisoners or civilians, looting or desecration of religious buildings?

Medical Background Questions

Have you had a medical exam performed by an IRCC authorized panel physician (doctor) within the last 12 months?

Tuberculosis

In the last 2 years, were you diagnosed with tuberculosis?

In the last 5 years, have you been in close contact with a person with tuberculosis?

General Medical Questions

Are you currently receiving dialysis treatment?

Have you had a drug or alcohol addiction causing you to be a threat to yourself or others, or to be hospitalized?

Have you had a mental health condition causing you to be a threat to yourself or others, or to be hospitalized?

Have you ever been diagnosed with syphilis?

Family Information

What is your current marital status?

Date of marriage or start of common-law relationship:

Spouse/Common-Law Partner

Surname or last name:

Given name or first name:

Date of birth:

Country or territory of birth:

When did the relationship with your spouse or common-law partner end?

Children

Do you have any biological, adopted or step-children?

Child 1: ARIN FAHMIDA ALAM

Surname or last name:

Given name or first name:

Date of birth:

Relationship:

Country or territory of birth:

Does this child have the same address as you?

Present Address:

If the child is not in Canada, will they accompany you to Canada?

Child 2: AFRIDI FARDIN HOSSAIN

Tell us about your parents

Father's Information

Surname or last name:

Given name or first name:

Relationship:

Date of birth:

This parent is deceased:

Date of death:

Country or territory of birth:

Mother's Information

Surname or last name:

Given name or first name:

Relationship:

Date of birth:

This parent is deceased:

Date of death:

Country or territory of birth:

Language of the Applicant

What is your native language or mother tongue?

Can you communicate in English and/or French?

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

Contact Information

Email address:

Confirm your email address:

Telephone type:

Telephone number country or territory:

Telephone number: