If you have read our eligibility page and you believe you are eligible for Citizenship and wish to retain our services you may wish to complete the questionnaire below and provide the information to our office. This information will help us to complete your application as soon as possible.

CITIZENSHIP QUESTIONNAIRE

We will require the following information in order to prepare your application:

  • Last name:
  • Given name:
  • Birth date:
  • Birth town or city/country:
  • Height:
  • Colour of eyes:
  • Do you want a different name to appear on your citizenship certificate?
  • If so, please provide the name you would like to appear on your certificate:
  • If so, please also provide the reason (i.e. shortened name on immigration document, legal name change, minor change in spelling, significant change in spelling):
  • Home address:
  • Mailing address:
  • Telephone numbers (home, cell, work):
  • Email address:
  • When did you first come to live in Canada:
  • Date you became a permanent resident (year/month/day):
  • Are you a citizen of any other countries:
  • If so, which countries:
  • Do you have PR status in any other country:
  • If so, which countries:
  • Please list your addresses in the last 4 years:
  • Please also provide us with the dates your resided at those addresses:
  • Please list your work and education history in the last 4 years:
  • Please also provide us with the dates of employment and education:
  • In the last 4 years:
  • Are you now or have you ever been an inmate of a penitentiary, jail, or reformatory, or prison?
  • Are you now or have you been on probation?
  • Are you now or have you been on parole?
  • In the past 3 years, have you been convicted of an indictable offense or an offense under the Citizenship Act?
  • Are you now, or have you ever been, under a removal order (have you been asked by Canadian officials to leave Canada)?
  • Are you now under investigation for or charged with a war crime or a crime against humanity or have you ever been convicted of a war crime or a crime against humanity?
  • In the past 5 years, have you had Canadian citizenship which had been taken away (revoked)?
  • List any other names including names used at birth, aliases and nicknames:

We will require the following documents in order to prepare your application:

  • A photocopy of your Record of Landing
  • A photocopy of both sides of your Permanent Resident Card
  • A photocopy of biographical pages of passports and/or travel documents
  • Photocopies of school records for yourself
  • Photocopy of 2 pieces of personal identification
  • A photocopy of both sides of your health card
  • 2 citizenship photos (Citizenship Photograph Specification page attached)

A photocopy of language evidence (i.e. the results of a CIC-approved third-party language test; a diploma, certificate or transcript of a secondary or post-secondary education in English or French, in Canada or abroad; OR evidence of achieving CLB/NCLC 4 in a government-funded language training program