Work Permit Intake · JSR Immigration Ltd.

Welcome

This form takes about 10–15 minutes. Your answers save automatically as you type. All information is sent securely to JSR Immigration Ltd. for your Work Permit application.

Work permit type*

* marks a required field. Please have your passport, current immigration status document, and full Canadian address ready before you start.

1Personal information

Copy your name exactly as it appears on your passport. If the full name (e.g., "Sandeep Singh") is in one field on your passport, put it in that same field here and leave the other blank.

Family name (surname)*

Given name(s) Leave this blank if your passport has no given name listed.

UCI number An 8 or 10-digit number found at the top of any letter you've received from IRCC.

Date of birth* Tap to pick from a calendar. Must match your passport.

Country of birth*

Country of citizenship*

2Current immigration status

Status in Canada* Pick "Implied Status" if you applied to extend before your last permit expired and are waiting for a decision.

Valid from

Valid to* The expiry date on your current permit or status document.

3Passport

Passport number* Found on the photo page of your passport — usually top-right.

Country of issue* The country that issued your passport — same as your nationality shown on it.

Issue date

Expiry date* Make sure your passport will stay valid past your application's processing time.

4Marital status

Status*

Partner first name

Partner last name

Partner DOB

Date of marriage / relationship

Date of separation / divorce / passing

5Contact & address

Phone*

Email*

Alternate phone

Street address* Your current Canadian residential address — no PO boxes.

City*

Province*

Postal code*

6Entry to Canada

First entry date* The FIRST time you ever entered Canada — not your most recent trip.

First port of entry* Airport (e.g. YYZ, YVR) or land-border name where you first arrived.

Most recent entry date

Most recent port of entry

Purpose of first entry to Canada* What status did you first enter Canada on?

7Education in Canada

List every program at every Designated Learning Institution (DLI). Add more as needed.

8Employment history (Canada)

All Canadian jobs since arrival, including part-time. Most recent first.

9Admissibility questions

All questions are required. Answer each truthfully. Misrepresentation under IRPA s.40 can lead to a 5-year ban.

11Application background

Tell us which program you're applying under. Add anything else we should know.

Under which program are you applying?* Name the specific IRCC program or stream you qualify under.

Anything else you'd like to tell us? Optional. Tell us about previous applications, refusals, or anything else you'd like to explain about your situation.

12Declaration & signature

Declaration of accuracy. I declare that the information provided in this form is true, complete, and accurate to the best of my knowledge. I understand that providing false or misleading information constitutes misrepresentation under section 40 of the Immigration and Refugee Protection Act (IRPA), which may result in a finding of inadmissibility.

Authorization. I authorize JSR Immigration Ltd. and its licensed representatives (RCIC #R712841) to use the information in this form to prepare and submit my Work Permit application and to communicate with IRCC on my behalf.

I confirm the information above is true, complete, and accurate. I authorize JSR Immigration Ltd. to act as my representative.

Type your full name* Your legal name as on your passport — this serves as your signature.

Date* Today's date (auto-filled).

Signature (draw with finger or mouse)

Optional. Your typed name above also serves as a legal signature.

Form received

Your intake has been securely submitted.

A consultant will review and contact you within 1–2 business days.

RCIC #R712841

JSR Immigration Ltd.

Brampton, Ontario · info@jsrimmigration.com