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CAIPS/GCMS Notes
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Entire File
Application Form
(Details of the Principal Applicant)
*
= Required Fields
*
First Name/ Given Name
:
Middle Name
:
*
Last Name/ Family Name
:
*
Visa Processing Office
:
Select from List
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Asia and Pacific
-------------------------------------------------
Bangkok, Thailand
Beijing, China
Chandigarh, India
Colombo, Sri Lanka
Dhaka, Bangladesh
Ho Chi Minh City, Vietnam
Hong Kong, China
Islamabad, Pakistan
Jakarta, Indonesia
Kuala Lumpur, Malaysia
Manila, Philippines
New Delhi, India
Seoul, Korea
Shanghai, China
Singapore, Singapore
Sydney, Australia
Taipei, Taiwan
Tokyo, Japan
-------------------------------------------------
Africa and Middle East
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Abidjan, Ivory Coast
Abu Dhabi, United Arab Emirates
Accra, Ghana
Addis Ababa, Ethiopia
Algiers, Algeria
Amman, Jordan
Antananarivo, Madagascar
Asmara, Eritrea
Bamako, Mali
Beirut, Lebanon
Cairo, Egypt
Dakar, Senegal
Damascus, Syria
Harare, Zimbabwe
Kigali, Rwanda
Kinshasa, Congo
Lagos, Nigeria
Nairobi, Kenya
Ouagadougou, Burkina Faso
Pretoria, South Africa
Rabat, Morocco
Riyadh, Saudi Arabia
Tehran, Iran
Tel Aviv, Israel
Tripoli, Libya
Tunis, Tunisia
Yaounde, Cameroon
-------------------------------------------------
Europe
-------------------------------------------------
Ankara, Turkey
Belgrade, Serbia
Berlin, Germany
Bucharest, Romania
Kyiv, Ukraine
London, United Kingdom
Moscow, Russia
Paris, France (CAIPS Notes may be in French)
Prague, Czech Republic
Rome, Italy
Vienna, Austria
Warsaw, Poland
-------------------------------------------------
Western Hemisphere
-------------------------------------------------
Bogota, Colombia
Buenos Aires, Argentina
Buffalo, N.Y., U.S.A.
Caracas, Venezuela
Georgetown, Guyana
Guatemala City, Guatemala
Havana, Cuba
Kingston, Jamaica
Lima, Peru
Mexico City, Mexico
Ottawa, Canada
Panama City, Panama
Port-au-Prince, Haiti
Port of Spain, Trinidad and Tobago
San Jose, Costa Rica
San Salvador, El Salvador
Santiago, Chile
Santo Domingo, Dominican Republic
Sao Paulo, Brazil
Quito, Ecuador
Vegreville, Canada
Other (please specify in 'Additional Notes' below)
*
Invited for a Visa Interview?
:
NO
YES
If yes, enter
Interview Office location
Interview Date
(mm/dd/yyyy)
*
File Number
:
B
S
V
W
E
F
-
-
-
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*
Date of Birth
:
Month
January
February
March
April
May
June
July
August
September
October
November
December
Date
01
02
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04
05
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10
11
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14
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16
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19
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25
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29
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31
Year
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
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1951
1950
1949
1948
1947
1946
1945
1944
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1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
*
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Alternate E-mail
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Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua & Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Azores
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire
Bosnia & Herzegovina
Botswana
Brazil
British Indian Ocean Ter
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Canary Islands
Cape Verde
Cayman Islands
Central African Republic
Chad
Channel Islands
Chile
China
Christmas Island
Cocos Island
Columbia
Comoros
Congo
Cook Islands
Costa Rica
Cote D'Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Ter
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Great Britain
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guyana
Haiti
Hawaii
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea North
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Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malaysia
Malawi
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Midway Islands
Moldova
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Nambia
Nauru
Nepal
Netherland Antilles
Netherlands
Nevis
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Norway
Oman
Pakistan
Palau Island
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Island
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
St Barthelemy
St Eustatius
St Helena
St Kitts-Nevis
St Lucia
St Maarten
St Pierre & Miquelon
St Vincent & Grenadines
Saipan
Samoa
Samoa American
San Marino
Sao Tome & Principe
Saudi Arabia
Senegal
Seychelles
Serbia & Montenegro
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Tahiti
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad & Tobago
Tunisia
Turkey
Turkmenistan
Turks & Caicos Is
Tuvalu
Uganda
Ukraine
United Arab Emirates
United States of America
Uruguay
Uzbekistan
Vanuatu
Vatican City State
Venezuela
Vietnam
Virgin Islands (Brit)
Virgin Islands (USA)
Wake Island
Wallis & Futana Is
Yemen
Zaire
Zambia
Zimbabwe
Additional Notes
:
If, other than for an interview, your file has been transferred from the processing office then please let us know
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Who needs to submit the Consent form
A consent form is required of each
adult individual
(over 18 years of age) whose name is mentioned in the immigration application. For example, as a principal applicant you should enclose a copy from your self and if applicable a copy from your spouse or adult dependants.
Being sponsored to Canada?
If you or your family have been sponsored to come to Canada then the consent of the sponsor as well as the principal applicant is required. In addition, consent from other family members being sponsored such as a spouse or dependent children over the age of 18 is also required.
Matching the Consent with the File number
The principal applicants file number will be used as reference for all the consent forms.
Date on the Consent form
Always submit a recent Consent form even if it's a repeat order. The Consent form should be dated within 30 days of placing the order.
If the consent form for all individuals is not provided then CIC will sever information related to the missing consent form.
After submitting this form you will be redirected to complete Step 2 & Step 3
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June 19, 2013
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