1. I am filling out the form for

   Principal Applicant Other family member

The information you enter must match the information in the immigration documents for this registrant.

If the registrant uses a name or names different from those in their immigration documents, they can be provided to a settlement worker after the registration is completed.

1. First name
2. Last nameif you only have one name, use this field
3. Date of birth
4. Country of origin < select one > Aaland IslandsAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBritish Virgin IslandsBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic ofCongo, Republic ofCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong Kong SAR, ChinaHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian Territory, OccupiedPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaStatelessSudanSurinameSvalbard and Jan Mayen IslandsSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Virgin IslandsUruguayUSSRUzbekistanVanuatuVatican City State (Holy See)VenezuelaVietnamWallis and Futuna IslandsWestern SaharaYemenYugoslaviaZambiaZimbabwe
5. Gender

   Female Male

6. Marital status < select one > Common lawDivorcedMarriedSeparatedSingleWidowWidower

1. Native language < select one > AcholiAfrikaansAlbanianAmharicArabicAramaicArmenianAzeriBabaraBambaraBanglaBengaliBhutaneseBisayaBosnianBulgarianBurmeseChichewaChinese (Cantonese)Chinese (Mandarin)CreoleCroatianCzechDanishDariDutchEnglishFilipinoFinnishFrenchFuldeldGermanGreekGujaratHausaHebrewHindiHungarianIgboIndonesianItalianJamaican PatoisJapaneseKanundaKapampanganKarenKhmerKinyarwandaKirundiKiswahiliKoreanKurdishLimbaLingalaLithuanianLormaLugandaMacedonianMalayMalayalamMalteseManipuriNepaliPashtoPersianPolishPortuguesePunjabiRohingyaRomanianRussianSerbianSerbo-Croation (Croato-Serbian)SindhiSinhaleseSomaliSpanishSwahiliSwahiliSwatiTagalogTaiwaneseTamilTeluguThaiTiminiTurkishUkrainianUrduUzbekVietnameseYoruba
2. English language proficiency

   Fluent Advanced Intermediate Basic None

3.  
4. Additional language spoken if you speak more than one additional language, please indicate it in the 'Additional Information' section of the form below < select one > AcholiAfrikaansAlbanianAmharicArabicAramaicArmenianAzeriBabaraBambaraBanglaBengaliBhutaneseBisayaBosnianBulgarianBurmeseChichewaChinese (Cantonese)Chinese (Mandarin)CreoleCroatianCzechDanishDariDutchEnglishFilipinoFinnishFrenchFuldeldGermanGreekGujaratHausaHebrewHindiHungarianIgboIndonesianItalianJamaican PatoisJapaneseKanundaKapampanganKarenKhmerKinyarwandaKirundiKiswahiliKoreanKurdishLimbaLingalaLithuanianLormaLugandaMacedonianMalayMalayalamMalteseManipuriNepaliPashtoPersianPolishPortuguesePunjabiRohingyaRomanianRussianSerbianSerbo-Croation (Croato-Serbian)SindhiSinhaleseSomaliSpanishSwahiliSwahiliSwatiTagalogTaiwaneseTamilTeluguThaiTiminiTurkishUkrainianUrduUzbekVietnameseYoruba

Please enter the address of your temporary accommodation if you don't have permanent housing yet.

If this registrant is not the Principal Applicant and this person doesn't have their own email address or phone number, please fill out the Principal Applicant's information.

1. Email
2. Phone number
3. Address
4.  
5. City/Town < select one > AlbanyAlbertonAlexandraAmherstAuroraBedequeBelfastBell RiverBonshawBorden-CarletonBrackleyBrackley BeachBreadalbaneBrookfieldCalgaryCanoe CoveCardiganCharlottetownClyde RiverCornwallCrapaudCumberlandDonaghDonaldsonDunstaffnageEast PointEbenezerEdmontonFairviewFrederictonGeorgetownGrand RiverGrand TracadieGreen GablesHalifaxHamptonHarringtonHazelbrookHunter RiverKensingtonKeppochKingstonKinkoraLondonLong CreekMarkhamMeadowbankMellvilleMermaidMermaidMilton StationMiscoucheMississaugaMontagueMontrealMorellMount HerbertMount StewartMurray HarbourMurray RiverNew GlasgowNew HavenNorth RusticoNorth WiltshireO'LearyOakvilleOttawaOyster BedPownalPrimroseRichmond HillRose ValleyScarboroughSea ViewSherwoodSlemon ParkSourisSouth MelvilleSparksSt CatherinesSt. John'sSt. LawrenceSt. LouisSt. Peter's BaySt. RochStanchelStratfordSummersideSurreyTignishTorontoTryonVancouverVernon BridgeVernon RiverVictoriaWaterlooWellingtonWinsloeYork
6. Postal Code
7. This is a permanent address

   Yes No

1. Date of arrival in Canada
2. Date of arrival in PEI
3. Immigration ID UCI, FOSS or IMM number on the immigration document
4. Immigration document type < select one >Landing papersWork permitStudy permitVisitor recordOther
5. Immigration document .jpg or .png image files not exceeding 2MB in size are accepted

1. Education level completed or last attended < select one > No formal educationSome elementary schoolElementary schoolHigh schoolCollegeSome universityUniversity degreePostgraduate degree
2. Occupation < select one > AerospaceAgricultureBioscience or Food ScienceFinancial ServicesHealth ServicesHospitality/Tourism/Customer ServiceInformation TechnologyManufacturing and ProcessingOtherStudentTrades
3. Social Insurance Number (SIN) Canadian SIN, if the registrant already obtained one - needed for employment purposes for adults and certain benefits for minors

1. Special needs or health issuese.g. physical disability, chronic illness, allergies
2. Interestsspecial interests or hobbies
3. Additional commentsanything you wish to communicate that is not covered in the form