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Registration Form - Immigration Canada
Last Name
Please use only English alphabetic characters.
First Name
Please use only English alphabetic characters.
Email
Email Confirmation
Age
Gender
Male
Female
Marital Status
Single
Married
Common-law
Divorced
Widowed
Do you have children accompanying you to Canada?
Yes
No
Number of children aged 0 to 12
0
1
2
3
4
5+
Number of children aged 13 to 21
0
1
2
3
4
5+
Country of residence
-- Select your country --
Afghanistan
Afrique du Sud
Albanie
Algérie
Allemagne
Andorre
Angola
Arabie Saoudite
Argentine
Arménie
Australie
Autriche
Azerbaïdjan
Bahamas
Bahreïn
Bangladesh
Belgique
Belize
Bénin
Bhoutan
Biélorussie
Bolivie
Bosnie-Herzégovine
Botswana
Brésil
Brunei
Bulgarie
Burkina Faso
Burundi
Cambodge
Cameroun
Canada
Cap-Vert
Chili
Chine
Chypre
Colombie
Comores
Congo
Congo (RDC)
Corée du Nord
Corée du Sud
Costa Rica
Côte d’Ivoire
Croatie
Cuba
Danemark
Djibouti
Dominique
Égypte
Émirats arabes unis
Équateur
Érythrée
Espagne
Estonie
États-Unis
Éthiopie
Fidji
Finlande
France
Gabon
Gambie
Géorgie
Ghana
Grèce
Guatemala
Guinée
Guinée-Bissau
Guinée équatoriale
Guyana
Haïti
Honduras
Hongrie
Inde
Indonésie
Irak
Iran
Irlande
Islande
Israël
Italie
Jamaïque
Japon
Jordanie
Kazakhstan
Kenya
Kirghizistan
Koweït
Laos
Lesotho
Lettonie
Liban
Liberia
Libye
Liechtenstein
Lituanie
Luxembourg
Macédoine du Nord
Madagascar
Malaisie
Malawi
Maldives
Mali
Malte
Maroc
Maurice
Mauritanie
Mexique
Moldavie
Monaco
Mongolie
Monténégro
Mozambique
Myanmar
Namibie
Népal
Nicaragua
Niger
Nigéria
Norvège
Nouvelle-Zélande
Oman
Ouganda
Ouzbékistan
Pakistan
Panama
Papouasie-Nouvelle-Guinée
Paraguay
Pays-Bas
Pérou
Philippines
Pologne
Portugal
Qatar
République centrafricaine
République dominicaine
République tchèque
Roumanie
Royaume-Uni
Russie
Rwanda
Sainte-Lucie
Salvador
Samoa
Sao Tomé-et-Principe
Sénégal
Serbie
Seychelles
Sierra Leone
Singapour
Slovaquie
Slovénie
Somalie
Soudan
Soudan du Sud
Sri Lanka
Suède
Suisse
Suriname
Syrie
Tadjikistan
Tanzanie
Tchad
Thaïlande
Togo
Trinité-et-Tobago
Tunisie
Turkménistan
Turquie
Ukraine
Uruguay
Venezuela
Vietnam
Yémen
Zambie
Zimbabwe
Education
Secondary
Technical
College
Bachelor's
Master's
Doctorate
Is your diploma recognized by the government?
Yes
No
Work Experience
Full-time work experience in the last 6 years
Less than 1 year
1 year
2 years
3 years
4 years
5 years
6 years or more
French Skills
Basic
Intermediate
Good
Very good
Basic
Intermediate
Good
Very good
Basic
Intermediate
Good
Very good
Basic
Intermediate
Good
Very good
English Skills
Basic
Intermediate
Good
Very good
Basic
Intermediate
Good
Very good
Basic
Intermediate
Good
Very good
Basic
Intermediate
Good
Very good
Connections to Canada
Do you know someone living in Canada?
Yes
No
Have you ever been to Canada?
Yes
No
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