ANYVISA SERVICES CORP.
Immigration Department
EXT: AMT
CONFIDENTIAL
Initial Data for Immigration Applications
Please NOTE:
- All NAMES Must Be Written as in the Official Travel DOCUMENT – PASSPORT.
- All ADDRESSES Must Include the POSTAL CODE and Be Full;
- All DATES Must Be Written in the Following Format: DD/MM/YYYY;
- All QUESTIONS That Are Not Related Must Be Left with the “N/A” Mark;
- All LIFE PERIODS Must Be Covered with NO GAPS Whatsoever.
- If Some Answer Require Extended Space, Please Add Additional Rows to the Required Table or Use Additional Sheet of
Paper to Provide Full Information
-
PLEASE RE-SAVE THIS DOCUMENT, TYPE IN ALL ANSWERS AND RETURN VIA E-MAIL TO US.
Applicant’s Information
1.
First Name
2.
Last Name/Surname
3.
Previous names (if applicable)
4.
Maiden Name (if applicable)
5.
Your Full Name Written in Your Native
Language or Script (for example Arabic, Urdu,
Chinese, Korean, Russian etc.)
6.
Have you ever used any other name
(Nickname, alias, etc.)?
If Yes, please indicate it:
7.
Country of Residence
CANADA
8.
Date of Birth (DD/MM/YYYY)
07/07/2000
9.
Place of Birth (City, Country)
DUBAI
10.
Have You Ever Resided in Any Other Country
for More than 6 months. If Yes
please indicate these countries:
Yes ☑
SAUD
CHAUDHRY
n/a
SAUD
from DD/MM/YYYY to DD/MM/YYYY:
statuses:
11.
12.
Marital Status
If you check marked Married, Divorced
or Widowed, please indicate the
following:
Date on Which You Were
Married/Entered in Common-Law
Relationship DD/MM/YYYY
If you are married, please confirm how was
your marriage conducted:
Have you been married or in common-law
relationship previously?
If you answered Yes, please provide the
following information:
‫سعود چودھری‬
Yes ☐
No
☑
UAE
No
☐
UAE
07/07/2000 – 14/12/2018 and 15/10/2020 to 08/08/2021
STUDENT
Married
Never Married ☑
Common-Law ☐
Legally Separated ☐
Divorced ☐
Widowed ☐
N/A
In person ☐
Yes
☐
By Proxy ☐
No
☐
1|Page
14.
(a) Full Name of Previous
Spouse/Partner
(b) Date of Birth of Previous
Spouse/Partner (DD/MM/YYYY)
(c) Exact Period of Time of Previous
Marriage//Common Law
Relationship (DD/MM/YYYY)
Country of Your Current Citizenship
If you currently hold more than one
citizenship, please indicate those:
Your Native Language
15.
Your Height
16.
Color of Your Eyes
Black ☑
17.
Have you ever passed language professional
test
Language Test Result:
IELTS ☑
13.
18.
N/A
DD/MM/YYYY
From
PAKISTAN
URDU
179cm
Blue ☐
Green ☐
TOEFL ☐
Grey ☐
TEF
☐
6.5 overall
Speaking
Reading
Listening
Writing
Speaking
Reading
Listening
Writing
French
20.
Brown ☐
CELPIP ☐
English
19.
DD/MM/YYYY
To
7.5
5.5
7.5
6.0
Your Mailing Address
Country
CANADA
Postal Code
R3T3K8
State/Province/District
MANITOBA
City/Town
WINNIPEG
Is your Residential Same as Your Mailing
Address?
Street Name
Street #
Unit
Yes
BRYN MAWR
n/a
95
☑
No
☐
If the answer is No, please indicate the following:
21.
Country
Postal Code
State/Province/District
City/Town
Phone Number (including country and area code)
22.
Fax Number (including country and area code)
23.
Email Address
24.
Where Do You Intend to Live in Canada?
(city, province)
Do you have an offer of employment in
Canada approved by Service Canada (called
LMIA)?
Are you currently working in Canada under
any Work Permit?
Have you or your spouse previously completed
a program of full-time study of at least two
years at a post-secondary institution in
Canada?
If Yes, please provide details
25.
26.
27.
28.
Have you or your spouse previously worked
full-time in Canada?
If Yes, please provide details
Street Name
Street #
Unit
+1 (204) 951-4560
N/A
Saudchaudhry4@gmail.com
Toronto/ Ontario
Yes
☐
No
☑
Yes
☐
No
☑
Yes
☐
No
☑
Yes
☐
No
☑
2|Page
29.
Work Experience/Personal History since the age of 18, or the past 10 years, whichever is most recent (detail address,
position, dates) – and attach very detailed resume. If you were not working, provide information on what you were doing (for
example: unemployed, studying, travelling, etc). Please don’t leave any gaps
From
To
Activity /
City & Country
Status in the country
Name of Company
(ex. Citizen, Visitor,
DD/MM/YYYY
DD/MM/YYYY
Occupation
Worker, Student etc.)
30.
31.
08/09/2017
06/05/2018
07/05/2018
06/01/2019
07/01/2019
TO DATE
DUBAI,UAE
Studying
DIDN’T STUDY..
TRAVELLED TO
TORONTO TO
VISIT FAMILY.
WAS WAITING
FOR UNIVERSITY
AND CANADIAN
STUDY PERMIT
APPROVAL
STUDYING
RESIDENT
DUBAI,UAE
RESIDENT
WINNIPEG ,
CANADA
STUDENT
UNIVERSITY OF
WOLLONGONG IN
DUBAI
N/A
UNIVERSITY OF
MANITOBA
List of all addresses where you have lived since the age of 18, or the past 10 years, whichever is most recent.
Please don’t leave any gaps
From
To
Unit
Street
Street
City/
Province/
Postal
DD/MM/YYYY
DD/MM/YYYY
Number
Number
Name
Town
State
Code
Muwaileh
Sharjah
24 /03/ 2011
15/12/2018
402B
S112
Sharjah
10429
16/12/2018
02/01/2019
1110
9
03/01/2019
25/04/2019
24/04/2019
14/05/2019
206
1110
120
9
15/05/2019
13/08/2019
402B
14/08/2019
01/06/2020
02/06/2020
commercial
Four winds
drive
Dafoe Road
Toronto
UAE
Ontario
M3J2S8
Canada
Canada
Canada
Toronto
Manitoba
Ontario
R3T 6B3
Four
Winds
Drive
S112
Muwaileh
commercial
Sharjah
Sharjah
10429
UAE
1133
N/A
Lee
boulevard
Winnipeg
Manitoba
R3T2P
3
Canada
14/10/2020
95
n/a
Bryn
Mawr
Winnipeg
Manitoba
Canada
15/10/2020
08/08/2021
402B
S112
Muwaileh
Commercial
Sharjah
Sharjah
R3T3K
8
10429
09/08/2021
TO DATE
95
N/A
Bryn Mawr
Winnipeg
Manitoba
Rt3k8
Canada
Have You Ever Served in a Military
If Yes, please indicate the following:
Country
From
DD/MM/YY
YY
To
DD/MM/YYYY
Yes
Winnipeg
Country
☐
Branch of Service, Unit Numbers
and Names of Your Commanding
Officers
M3J2S
8
No
Rank (s)
Dates and
Places of Any
Active Combat
UAE
☑
Reason for End
of Service
n/a
32.
Do you have a relative living in Canada who is
a citizen or permanent resident of Canada?
If answered Yes, please provide details:
Yes
☑
No
Full Name and Relationship to you
SAAD CHAUDHRY,COUSIN
BACKGROUND CHECK
Have you, or any of your family members listed in your application ever
been refused any visa, immigration status, were deported or denied entry in
CANADA or in ANY COUNTRY in the world?
Yes
☐
City/Province
ONTARIO/TORONTO
☐
No
☑
3|Page
been convicted of a crime or offence in Canada for which a pardon has not been
granted under the Criminal Records Act of Canada?
been convicted of, or are you currently charged with, on trial for, or party to a
crime or offence, or subject of any criminal proceedings in any country?
made previous claims for refugee protection in Canada or at a Canadian visa office
abroad, in any other country or countries, or with the United Nations High
Commissioner for Refugees (UNHCR)?
been refused refugee status, or an immigrant or permanent resident visa (including
a Certificat de selection du Quebec (CSQ) or application to the Provincial Nominee
Program) or visitor or temporary resident visa, to Canada or any other country
been refused admission to, or ordered to leave Canada or any other country?
been involved in an act of genocide, a war crime or in the commission of a crime
against humanity?
used, planned or advocated the use of armed struggle or violence to reach political,
religious or social objectives?
been associated with a group that used, uses, advocated or advocates the use of
armed struggle or violence to reach political, religious or social objectives?
been a member of an organization that is or was engaged in an activity that is part
of a pattern of criminal activity?
been detained, incarcerated, or put in jail?
had any serious disease or physical or mental disorder?
If your answer to any of these questions is YES, provide details below
Yes
☐
No
☑
Yes
☐
No
☑
Yes
☐
No
☑
Yes
☐
No
☑
Yes
Yes
☐
☐
No
No
☑
☑
Yes
☐
No
☑
Yes
☐
No
☑
Yes
☐
No
☑
Yes
Yes
☐
☐
No
No
☑
☑
n/a
Additional Information
1.
List any Government Positions (such as civil servant, judge, police, officer, employee in a security organization) you have
held.
Do Not Use Abbreviations.
From
YYYY/MM/DD
To
YYYY/MM/DD
Country and Level of
Jurisdiction (e.g. national, regional,
Department/Branch
Activities and/or position
held
municipal)
N/A
Membership of Association with Organizations
From
To
Name of Organization
YYYY/MM/DD YYYY/MM/DD
2.
Type of organization
Activities and/or
positions held within
organization
City and Country
N/A
PREVIOUS APPLICATION – CANADA
Have you ever applied to enter or remain in Canada?
Original (very first) entry to Canada
Date DD/MM/YYYY, Place, Purpose of visit
Last (most recent) entry to Canada
Date DD/MM/YYYY, Place, Purpose of visit
Have you ever applied for Permanent Residence in Canada?
If Yes, please provide details
(date when applied; under what immigration program;
what was the decision on your application, etc.):
Yes ☑
No ☐
03/08/2006 , TORONTO, TOURIST VISIT
09/08/2021, WINNIPEG, STUDIES
Yes
n/a
☐
No
☑
4|Page
Spouse Information
1.
First Name
2.
Last Name/Surname
3.
Previous names (if applicable)
4.
Maiden Name (if applicable)
5.
6.
Your Full Name Written in Your Native
Language or Script (for example Arabic, Urdu,
Chinese, Korean, Russian etc.)
Country of Residence
7.
Date of Birth (DD/MM/YYYY)
8.
Place of Birth (City, Country)
9.
n/a
Have You Ever Resided in Any Other Country
for More than 6 months. If Yes
please indicate these countries:
from DD/MM/YYYY to DD/MM/YYYY:
☐
Yes
No
☐
statuses:
10.
11.
Have you been married or in common-law
relationship previously?
If you answered Yes, please provide the following
information:
(d) Full Name of Previous
Spouse/Partner
(e) Date of Birth of Previous
Spouse/Partner (DD/MM/YYYY)
(f) Exact Period of Time of Previous
Marriage/Common Law Relationship
(DD/MM/YYYY)
Country of Your Current Citizenship
If you currently hold more than one
citizenship, please indicate those:
Yes
No
DD/MM/YYYY
From
12.
Your Native Language
13.
Your Height
14.
Color of Your Eyes
Black
15.
Have you ever passed language professional test
IELTS ☐
16.
Language Test Result:
17.
☐
☐
Blue ☐
Brown ☐
CELPIP ☐
To
Green ☐
TOEFL ☐
☐
DD/MM/YYYY
Grey ☐
TEF
☐
N/A
English
Speaking
Reading
Listening
Writing
French
Speaking
Reading
Listening
Writing
Your Mailing Address
Country
Postal Code
State/Province/District
City/Town
Street Name
Street #
Unit
5|Page
18.
Is your Residential Same as Your Mailing
Address?
Yes
☐
☐
No
If the answer is No, please indicate the following:
19.
Country
Postal Code
State/Province/District
City/Town
Phone Number (including country and area code)
20.
Fax Number (including country and area code)
21.
Email Address
22.
Where Do You Intend to Live in Canada? (city,
province)
Work Experience/Personal History since the age of 18, or the past 10 years, whichever is most recent (detail address, position,
dates) – and attach very detailed resume. If you were not working, provide information on what you were doing (for example:
unemployed, studying, travelling, etc). Please don’t leave any gaps
From
To
Activity / Occupation
City & Country
Status in the
Name of Company
DD/MM/YYYY
DD/MM/YYYY
country
23.
Street Name
Street #
Unit
(ex. Citizen, Visitor,
Worker, Student etc.)
24.
25.
List of all addresses where you have lived since the age of 18, or the past 10 years, whichever is most recent.
Please don’t leave any gaps
From
To
Unit
Street
Street
City/
Province/
Postal
DD/MM/YYYY DD/MM/YYYY Number Number
Name
Town
State
Code
Have You Ever Served in a Military
If Yes, please indicate the following:
Country
26.
From
DD/MM/YYYY
To
DD/MM/YYYY
Yes
☐
No
Branch of Service, Unit Numbers
and Names of Your Commanding
Officers
Do you have a relative living in Canada who is a
citizen or permanent resident of Canada?
If answered Yes, please provide details:
Yes
Rank (s)
Dates and
Places of Any
Active Combat
☐
☐
Reason for
End of Service
No
Full Name and Relationship to you
BACKGROUND CHECK
Have you, or any of your family members listed in your application ever
been refused any visa, immigration status, were deported or denied entry in
CANADA or in ANY COUNTRY in the world?
been convicted of a crime or offence in Canada for which a pardon has not been
granted under the Criminal Records Act of Canada?
been convicted of, or are you currently charged with, on trial for, or party to a crime or
offence, or subject of any criminal proceedings in any country?
made previous claims for refugee protection in Canada or at a Canadian visa office
abroad, in any other country or countries, or with the United Nations High
Commissioner for Refugees (UNHCR)?
been refused refugee status, or an immigrant or permanent resident visa (including a
Certificat de selection du Quebec (CSQ) or application to the Provincial Nominee
Program) or visitor or temporary resident visa, to Canada or any other country
Country
☐
City/Province
Yes
☐
No
☐
Yes
☐
No
☐
Yes
☐
No
☐
Yes
☐
No
☐
Yes
☐
No
☐
6|Page
been refused admission to, or ordered to leave Canada or any other country?
been involved in an act of genocide, a war crime or in the commission of a crime
against humanity?
used, planned or advocated the use of armed struggle or violence to reach political,
religious or social objectives?
been associated with a group that used, uses, advocated or advocates the use of armed
struggle or violence to reach political, religious or social objectives?
been a member of an organization that is or was engaged in an activity that is part of a
pattern of criminal activity?
been detained, incarcerated, or put in jail?
had any serious disease or physical or mental disorder?
If your answer to any of these questions is YES, provide details below
Yes
Yes
☐
☐
No
No
☐
☐
Yes
☐
No
☐
Yes
☐
No
☐
Yes
☐
No
☐
Yes
Yes
☐
☐
No
No
☐
☐
Additional Information
1.
List any Government Positions (such as civil servant, judge, police, officer, employee in a security organization) you have
held.
Do Not Use Abbreviations.
From
YYYY/MM/DD
To
YYYY/MM/DD
Country and Level of
Jurisdiction (e.g. national, regional,
Department/Branch
Activities and/or position
held
municipal)
n/a
Membership of Association with Organizations
From
To
Name of Organization
YYYY/MM/DD YYYY/MM/DD
2.
Type of organization
Activities and/or
positions held within
organization
City and Country
n/a
PREVIOUS APPLICATION – CANADA
Have you ever applied to enter or remain in Canada?
Original (very first) entry to Canada
Date DD/MM/YYYY, Place, Purpose of visit
Last (most recent) entry to Canada
Date DD/MM/YYYY, Place, Purpose of visit
Yes
☐
No
☐
Children’s Information
(If your Dependent Child is between the age of 18-22, he/she needs to fill out “Anyvisa Questionnaire” on their own)
If it doesn’t apply to you, please proceed to the next section
1.
First Name
2.
5.
Last Name/Surname /
previous names
Your Full Name Written in
Your Native Language or
Script (for example Arabic,
Urdu, Chinese, Korean,
Russian etc.)
Date of Birth
(DD/MM/YYYY)
Place of Birth (City, Country)
6.
Marital Status
3.
4.
n/a
Married ☐
Never Married/Single ☐
Common-Law ☐
Legally Separated ☐
Divorced ☐
Widowed ☐
Not Applicable, deceased ☐
7|Page
7.
8.
9.
Current Country of
Residence
Country of Your Current
Citizenship
If you currently hold more
than one citizenship, please
indicate those:
Current Residential Address
11.
Country
Postal Code
State/Province/District
City/Town
Knowledge of English or
French
Your Native Language
12.
Height
13.
Color of Eyes
14.
Highest level of education:
15.
Number of completed years
of education in total
Current Activity /
Occupation:
Email Address
10.
16.
17.
Street Name
Street #
Unit
English
Black
☐
☐
French
Blue
☐
Brown
☐
Green
☐
☐
Grey
☐
Children’s Information
If it doesn’t apply to you, please proceed to the next section
1.
First Name
2.
5.
Last Name/Surname /
previous names
Your Full Name Written in
Your Native Language or
Script (for example Arabic,
Urdu, Chinese, Korean,
Russian etc.)
Date of Birth
(DD/MM/YYYY)
Place of Birth (City, Country)
6.
Marital Status
7.
Current Country of
Residence
Country of Your Current
Citizenship
If you currently hold more
than one citizenship, please
indicate those:
Current Residential Address
3.
4.
n/a
Married ☐
Never Married/Single ☐
Common-Law ☐
8.
9.
11.
Country
Postal Code
State/Province/District
City/Town
Knowledge of English or
French
Your Native Language
12.
Height
10.
Legally Separated ☐
Divorced ☐
Widowed ☐
Not Applicable, deceased ☐
Street Name
Street #
Unit
English
☐
French
☐
☐
8|Page
13.
Color of Eyes
14.
Highest level of education:
15.
Number of completed years
of education in total
Current Activity /
Occupation:
Email Address
16.
17.
☐
Black
Blue
☐
Brown
☐
Green
☐
Grey
☐
☐
Children’s Information
(If your Dependent Child is between the age of 18-22, he/she needs to fill out “Anyvisa Questionnaire” on their own)
If it doesn’t apply to you, please proceed to the next section
1.
First Name
2.
Last Name/Surname / previous names
3.
4.
Your Full Name Written in Your Native
Language or Script (for example Arabic,
Urdu, Chinese, Korean, Russian etc.)
Date of Birth (DD/MM/YYYY)
5.
Place of Birth (City, Country)
6.
Marital Status
n/a
Married ☐
Never Married/Single ☐ Divorced ☐
Common-Law ☐
7.
Current Country of Residence
8.
9.
Country of Your Current Citizenship
If you currently hold more than one
citizenship, please indicate those:
Current Residential Address
10.
Country
Postal Code
State/Province/District
City/Town
Knowledge of English or French
11.
Your Native Language
12.
Height
13.
Color of Eyes
14.
Highest level of education:
15.
16.
Number of completed years of education
in total
Current Activity / Occupation:
17.
Email Address
Legally Separated ☐
Widowed ☐
Not Applicable, deceased ☐
Street Name
Street #
Unit
English
☐
French
☐
URDU
Black
☐
Blue
☐
Brown
☐
Green
☐
Grey
☐
Applicant’s Parents
Mother
1.
First Name
RABIA
2.
Last Name
SHUJAUDDIN
3.
Maiden Name/Name at birth
4.
Your Full Name Written in Your Native
Language or Script (for example Arabic,
Urdu, Chinese, Korean, Russian etc.)
RABIA ANWAR
‫رابعہ شجاع الدین‬
9|Page
5.
Date of Birth (DD/MM/YYYY)
6.
Place of Birth (City, Country)
7.
Marital Status
03/06/1977
DUBAI,UAE
Married ☑
Never Married/Single ☐
Common-Law ☐
8.
Current Residential Address
9.
Country
Postal Code
State/Province/District
City/Town
Email
10.
Current Activity / Occupation:
UAE
10429
SHARJAH
SHARJAH
Legally Separated ☐
Divorced ☐
Widowed ☐
Not Applicable, deceased ☐
Street Name
Street #
Unit
Muwailah Commercial
S112
402 B
Rabiashuja786@gmail.com
MOTHER
Applicant’s Parents
Father
1.
First Name
SHUJAUDDIN
2.
Last Name
CHAUDHRY
3.
Maiden Name/Name at birth
4.
Your Full Name Written in Your Native
Language or Script (for example Arabic,
Urdu, Chinese, Korean, Russian etc.)
5.
Date of Birth (DD/MM/YYYY)
25/07/1974
6.
Place of Birth (City, Country)
DUBAI , UAE
7.
Marital Status
Married ☑
SHUJAUDDIN
‫شجاع الدین چودھری‬
Never Married/Single ☐
Common-Law ☐
8.
Current Residential Address
9.
Country
Postal Code
State/Province/District
City/Town
Email
10.
Current Activity / Occupation:
UAE
10429
SHARJAH
SHARJAH
Legally Separated ☐
Street Name
Street #
Unit
Divorced ☐
Widowed ☐
Not Applicable, deceased ☐
Muwailah Commercial
S112
402B
Chshuja122@gmail.com
TECHNICAL
SUPPORT
ENGINEER
Spouse’s Parents
Mother
1.
First Name
2.
Last Name
3.
Maiden Name/Name at birth
4.
5.
Your Full Name Written in Your Native
Language or Script (for example Arabic,
Urdu, Chinese, Korean, Russian etc.)
Date of Birth (DD/MM/YYYY)
6.
Place of Birth (City, Country)
7.
Marital Status
N/A
Married ☐
Never Married/Single ☐
Common-Law ☐
Legally Separated ☐
Divorced ☐
Widowed
☐
Not Applicable, deceased ☐
10 | P a g e
8.
Current Residential Address
Country
Postal Code
Street Name
Street #
Unit
9.
State/Province/District
City/Town
Email
10.
Current Activity / Occupation:
Spouse’s Parents
Father
1.
First Name
2.
Last Name
3.
Maiden Name/Name at birth
4.
5.
Your Full Name Written in Your Native
Language or Script (for example Arabic,
Urdu, Chinese, Korean, Russian etc.)
Date of Birth (DD/MM/YYYY)
6.
Place of Birth (City, Country)
7.
Marital Status
N/A
Married ☐
Never Married/Single ☐
Common-Law ☐
8.
Current Residential Address
9.
Country
Postal Code
State/Province/District
City/Town
Email
10.
Current Activity / Occupation:
Divorced ☐
Legally Separated ☐
Widowed ☐
Not Applicable, deceased ☐
Street Name
Street #
Unit
late
If any of your or your spouse’s parents
deceased, please indicate name and date
(DD/MM/YYYY) and place (city,
country)
Applicant’s Siblings
1.
First Name
SUFYAN
2.
Last Name
CHAUDHRY
3.
Maiden Name/Name at birth
4.
Your Full Name Written in Your Native
Language or Script (for example Arabic,
Urdu, Chinese, Korean, Russian etc.)
5.
Relation to you (brother/sister/step-/half -)
BROTHER
6.
Date of Birth (DD/MM/YYYY)
29/11/2004
7.
Place of Birth (City, Country)
8.
Marital Status
SUFYAN
‫سفیان چودھری‬
DUBAI,UAE
Married ☐
Never Married/Single ☑
Common-Law ☐
9.
Legally Separated ☐
Divorced ☐
Widowed ☐
Not Applicable, deceased ☐
Current Residential Address
Country
Postal Code
State/Province/District
UAE
10429
SHARJAH
Street Name
Street #
Unit
Muwailah Commercial
S112
402 B
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10.
City/Town
Email
11.
Current Activity / Occupation:
SHARJAH
Sufyanchaudhry53@gmail.com
STUDENT
Applicant’s Siblings
1.
First Name
HIRA
2.
Last Name
CHAUDHRY
3.
Maiden Name/Name at birth
4.
Your Full Name Written in Your Native
Language or Script (for example Arabic,
Urdu, Chinese, Korean, Russian etc.)
5.
Relation to you (brother/sister/step-/half -)
6.
Date of Birth (DD/MM/YYYY)
7.
Place of Birth (City, Country)
8.
Marital Status
HIRA
‫ہیرا چودھری‬
SISTER
18/05/2009
DUBAI ,UAE
Married ☐
Never Married/Single ☑
Common-Law ☐
9.
Current Residential Address
10.
Country
Postal Code
State/Province/District
City/Town
Email
11.
Current Activity / Occupation:
1.
First Name
2.
Last Name
3.
Maiden Name/Name at birth
4.
5.
Your Full Name Written in Your Native
Language or Script (for example Arabic,
Urdu, Chinese, Korean, Russian etc.)
Relation to you (brother/sister/step-/half -)
6.
Date of Birth (DD/MM/YYYY)
7.
Place of Birth (City, Country)
8.
Marital Status
9.
Current Residential Address
10.
Country
Postal Code
State/Province/District
City/Town
Email
11.
Current Activity / Occupation:
Legally Separated ☐
Street Name
UAE
Street #
10429
Unit
SHARJAH
SHARJAH
Hiraprincess204@gmail.com
Divorced ☐
Widowed ☐
Not Applicable, deceased ☐
Muwailah Commerical
S112
402B
STUDENT
Applicant’s Siblings
n/a
Married ☐
Never Married/Single ☐
Divorced ☐
Widowed
☐
Common-Law ☐ Legally Separated ☐ Not Applicable, deceased ☐
Street Name
Street #
Unit
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Spouse’s Siblings
1.
First Name
2.
Last Name
3.
Maiden Name/Name at birth
4.
5.
Your Full Name Written in Your Native
Language or Script (for example Arabic,
Urdu, Chinese, Korean, Russian etc.)
Relation to you (brother/sister/step-/half -)
6.
Date of Birth (DD/MM/YYYY)
7.
Place of Birth (City, Country)
8.
Marital Status
9.
Current Residential Address
10.
Country
Postal Code
State/Province/District
City/Town
Email
11.
Current Activity / Occupation:
1.
First Name
2.
Last Name
3.
Maiden Name/Name at birth
4.
5.
Your Full Name Written in Your Native
Language or Script (for example Arabic,
Urdu, Chinese, Korean, Russian etc.)
Relation to you (brother/sister/step-/half -)
6.
Date of Birth (DD/MM/YYYY)
7.
Place of Birth (City, Country)
8.
Marital Status
9.
Current Residential Address
10.
Country
Postal Code
State/Province/District
City/Town
Email
11.
Current Activity / Occupation:
1.
First Name
2.
Last Name
3.
Maiden Name/Name at birth
n/a
Married ☐
Never Married/Single ☐
Divorced ☐
Widowed
☐
Common-Law ☐ Legally Separated ☐ Not Applicable, deceased ☐
Street Name
Street #
Unit
Spouse’s Siblings
n/a
Married ☐
Never Married/Single ☐
Divorced ☐
Widowed
☐
Common-Law ☐ Legally Separated ☐ Not Applicable, deceased ☐
Street Name
Street #
Unit
Spouse’s Siblings
N/A
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5.
Your Full Name Written in Your Native
Language or Script (for example Arabic,
Urdu, Chinese, Korean, Russian etc.)
Relation to you (brother/sister/step-/half -)
6.
Date of Birth (DD/MM/YYYY)
7.
Place of Birth (City, Country)
8.
Marital Status
4.
Married ☐
Never Married/Single ☐
Common-Law ☐
9.
Current Residential Address
10.
Country
Postal Code
State/Province/District
City/Town
Email
11.
Current Activity / Occupation:
Legally Separated ☐
Divorced ☐
Widowed ☐
Not Applicable, deceased ☐
Street Name
Street #
Unit
Spouse’s Siblings
1.
First Name
2.
Last Name
3.
Maiden Name/Name at birth
4.
5.
Your Full Name Written in Your Native
Language or Script (for example Arabic,
Urdu, Chinese, Korean, Russian etc.)
Relation to you (brother/sister/step-/half -)
6.
Date of Birth (DD/MM/YYYY)
7.
Place of Birth (City, Country)
8.
Marital Status
9.
Current Residential Address
10.
Country
Postal Code
State/Province/District
City/Town
Email
11.
Current Activity / Occupation:
1.
First Name
2.
Last Name
3.
Maiden Name/Name at birth
4.
5.
Your Full Name Written in Your Native
Language or Script (for example Arabic,
Urdu, Chinese, Korean, Russian etc.)
Relation to you (brother/sister/step-/half -)
6.
Date of Birth (DD/MM/YYYY)
7.
Place of Birth (City, Country)
N/A
Married ☐
Never Married/Single ☐
Divorced ☐
Widowed
☐
Common-Law ☐ Legally Separated ☐ Not Applicable, deceased ☐
Street Name
Street #
Unit
Spouse’s Siblings
N/A
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Married ☐
Never Married/Single ☐
Divorced ☐
Widowed
☐
Common-Law ☐ Legally Separated ☐ Not Applicable, deceased ☐
8.
Marital Status
9.
Current Residential Address
10.
Country
Postal Code
State/Province/District
City/Town
Email
11.
Current Activity / Occupation:
1.
First Name
2.
Last Name
3.
Maiden Name/Name at birth
4.
5.
Your Full Name Written in Your Native
Language or Script (for example Arabic,
Urdu, Chinese, Korean, Russian etc.)
Relation to you (brother/sister/step-/half -)
6.
Date of Birth (DD/MM/YYYY)
7.
Place of Birth (City, Country)
8.
Marital Status
Street Name
Street #
Unit
Spouse’s Siblings
n/a
Married ☐
Never Married/Single ☐
Common-Law ☐
9.
Current Residential Address
10.
Country
Postal Code
State/Province/District
City/Town
Email
11.
Current Activity / Occupation:
Legally Separated ☐
Divorced ☐
Widowed ☐
Not Applicable, deceased ☐
Street Name
Street #
Unit
If any of your or your spouse’s siblings
deceased, please indicate name and date
(DD/MM/YYYY) and place (city,
country)
n/a
Education
1.
Applicant’s Education
Number of years of education in total: 17
Number of years:
Elementary School
Secondary / High School
College/University
5
7
5
Level of Education
From
DD/MM/YYYY
To
DD/MM/YYYY
Primary School
09/09/2005
10/07/2010
Name of Institution
THE
WESTMINSTER
SCHOOL
City,
Country
DUBAI/UAE
Trade School or other
Post secondary school
n/a
Type of
Certificate/
Diploma Issued
PRIMARY
Field of Study
Academic
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Secondary
School/high school
08/09/2010
01/05/2017
University
08/09/2017
06/05/2018,
University
07/01/2019
TO DATE
VICTORIA
INTERNATIONAL
SCHOOL OF
SHARJAH
UNIVERSITY OF
WOLLONGONG
IN DUBAI
UNIVERSITY OF
MANITOBA
SHARJAH
/UAE
HIGH
SCHOOL
DIPLOMA
Academic
DUBAI,UAE
Did not
complete the
degree,
completed 2
semesters of
Bachelor of
business
administration
and some
courses taken
got transferred
to University of
Manitoba
BACHELORS
OF
COMMERCE
ACADMEIC
WINNIPEG ,
CANADA
ACADEMIC
N/A
2.
Spouse’s Education
Number of years of education in total: N/A
Elementary School
Number of years:
Level of Education
Secondary / High School
College/University
Trade School or other
Post secondary school
N/A
From
DD/MM/YYYY
To
DD/MM/YYYY
Name of Institution
City,
Country
Type of
Certificate/
Diploma Issued
Field of Study
Primary School
Secondary School
High School
College
University
☑ I confirm that the information given in this form is true, complete and accurate.
Date: 18/08/2021______________
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