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IN-CANADA APPLICATION FOR PERMANENT RESIDENT STATUS
This form is made available by Citizenship and Immigration Canada and is not to be sold to applicants.
(DISPONIBLE EN FRANÇAIS - IMM 5002 F)
IMM 5002 (06-2008) E
2.
Your full name (print your name as it appears on your passport, or on
your travel document or other valid identity document. Do not use initials
print names in full.)
All other names (include birth name, maiden, previous married name(s),
aliases and nicknames)
7.
Your country(ies)
of citizenship
1)
2)
9.
Last time you
entered Canada
Place
Date
11. Education
How many years of formal education do you have?
What is your highest level of completed education?
No secondary
Bachelor's degree
Secondary
Master's degree
Trade/Apprenticeship
PhD
Non-university certificate/diploma
Passport/Travel
document number
Country of issue
Date of issue
Citizenship and
Immigration Canada
Citoyenneté et
Immigration Canada
How many family members (including yourself) are included
in this application for permanent residence in Canada?
Languages
English:
French:
Speak
Read
Speak
Read
Write
Write
Native language
8. Country of last permanent residence (This is the country where you last
lived on a legal permanent basis. It is not a country where you had a
temporary status, such as foreign student or worker.)
Year
Month
Day
10. Your current marital status
Never
married
Married
Widowed
Legally
separated
Annulled
marriage
Divorced
Common-law
If you are married or in a common-law
relationship, provide the date on which
you were married or entered into the
common-law relationship
13. Your mailing address
14. Your residential address, if different from your mailing address
Other
Specify
15. Your telephone numbers
At home
Alternative
(for messages)
Fax
Family name
Given name(s)
Family name
Given name(s)
Year
Month
Day
3.
Your sex
Male
Female
Your place of birth
Town/City
Province
Country
4.
Your height
cm
in
OR
ft
5. Colour of your eyes
6.
Your date of birth
Year
Month
Day
12. Yo