Visitor Visa & Extension Free Assessment

First Name:

Last Name:

E-mail:

Telephone:

Street:

City:

State/Province:

Zip/Postal Code:

Country:

Nationality:

Age:

Current Employment Title:

How Long:

How many hours per week:

What is your current status in Canada?

Expiration date:

What is the purpose of your visit to Canada or stay in Canada?

Are you requesting an extension of your stay?
(You are in Canada and you request to extend your stay) Yes No

If so, how many times have you applied for an extension?

How long do you plan to stay in Canada?

Any issues regarding medical and/or criminality?

Funds available for my visit/stay in Canada: (CAD)

How did you hear about Border Connections?