Apply for Canada Electronic Travel Authorization (eTA)

Basic Details

• Do you have a passport issued by France or Venezuela?
  {Do you have a passport issued by France or Venezuela?:1}
• Which country issued your passport?
  {Which country issued your passport?:2}
• Are you a lawful permanent resident of the U.S. and have an alien registration card (Green Card)?
  {Are you a lawful permanent resident of the U.S. and have an alien registration card (Green Card)?:9}
• Has the printed expiry date on your Venezuelan passport already passed?
  {Has the printed expiry date on your Venezuelan passport already passed?:10}
• Do you have a unique client identifier (UCI)?
  {Do you have a unique client identifier (UCI)?:11}
• Are you applying on behalf of someone?
  {Are you applying on behalf of someone?:17}
• Are you applying on behalf of a minor child?
  {Are you applying on behalf of a minor child?:18}
• I am:
  {I am:20}
• Are you being paid to represent the applicant and complete the form on their behalf?
  {Are you being paid to represent the applicant and complete the form on their behalf?:21}
• Membership ID number:
  {Membership ID number:31}
• Which province or territory?
  {Which province or territory?:32}
• Surname(s) / last name(s):
  {Surname(s) / last name(s):22}
• Given name(s) / first name(s):
  {Given name(s) / first name(s):23}
• Name of firm, organization:
  {Name of firm, organization:30}
• Mailing address:
  {Mailing address:25}
• Postal code:
  {Postal code:33}
• Telephone number:
  {Telephone number:26}
• Fax number:
  {Fax number:27}
• Email address:
  {Email address:29}
• Representative's declaration:
  {Representative's declaration:34}
• Representative's authorization:
  {Representative's authorization:35}
• What travel document do you plan to use to travel to Canada?
  {What travel document do you plan to use to travel to Canada?:36}
• Select the code that matches the one on your passport:
  {Select the code that matches the one on your passport:39}
• Select the code that matches the one on your passport:
  {Select the code that matches the one on your passport:41}
• Are you a lawful permanent resident of the United States with a valid U.S. Citizenship and Immigration Services (USCIS) number?
  {Are you a lawful permanent resident of the United States with a valid U.S. Citizenship and Immigration Services (USCIS) number?:42}
• For this trip, will you use a national Israeli passport?
  {For this trip, will you use a national Israeli passport?:44}
• Are you a lawful permanent resident of the United States with a valid U.S. Citizenship and Immigration Services (USCIS) number?
  {Are you a lawful permanent resident of the United States with a valid U.S. Citizenship and Immigration Services (USCIS) number?:43}
• For this trip, will you use a passport issued by the Ministry of Foreign Affairs in Taiwan that includes your personal identification number?
  {For this trip, will you use a passport issued by the Ministry of Foreign Affairs in Taiwan that includes your personal identification number?:45}
• Taiwan personal identification number:
  {Taiwan personal identification number:61}
• Taiwan personal identification number (re-enter):
  {Taiwan personal identification number (re-enter):62}
• Are you a lawful permanent resident of the United States with a valid U.S. Citizenship and Immigration Services (USCIS) number?
  {Are you a lawful permanent resident of the United States with a valid U.S. Citizenship and Immigration Services (USCIS) number?:46}
• What is the nationality noted on this passport?:
  {What is the nationality noted on this passport?:47}
• What is the nationality noted on this passport?:
  {What is the nationality noted on this passport?:49}
• What is the nationality noted on this passport?
  {What is the nationality noted on this passport?:63}
• United States lawful permanent resident USCIS number:
  {United States lawful permanent resident USCIS number:54}
• United States lawful permanent resident alien registration card (Green Card) number (re-enter):
  {United States lawful permanent resident alien registration card (Green Card) number (re-enter):56}
• Date:
  {Date:57}
• What is the nationality noted on this passport?
  {What is the nationality noted on this passport?:58}

Passport details of applicant

• Passport number:
  {Passport number:66}
• Surname(s) / last name(s):
  {Surname(s) / last name(s):69}
• Given name(s) / first name(s):
  {Given name(s) / first name(s):70}
• Date of birth:
  {Date of birth:71}
• Gender:
  {Gender:72}
• Country/territory of birth:
  {Country/territory of birth:73}
• City/town of birth:
  {City/town of birth:74}
• Date of issue of passport:
  {Date of issue of passport:75}
• Date of expiry of passport:
  {Date of expiry of passport:76}

Personal details of applicant

• Additional nationalities:
  {Additional nationalities:81}
• Marital status:
  {Marital status:100}
• Have you ever applied for or obtained a visa, an eTA or a permit to visit, live, work or study in Canada?
  {Have you ever applied for or obtained a visa, an eTA or a permit to visit, live, work or study in Canada?:80}
• Unique client identifier (UCI) / Previous Canadian visa, eTA or permit number (optional):
  {Unique client identifier (UCI) / Previous Canadian visa, eTA or permit number (optional):119}
• Unique client identifier (UCI) / Previous Canadian visa, eTA or permit number (re-enter):
  {Unique client identifier (UCI) / Previous Canadian visa, eTA or permit number (re-enter):120}

Employment information

• Occupation:
  {Occupation:102}
• Job title of "Art, culture, recreation and sport occupations":
  {Job title of "Art, culture, recreation and sport occupations":104}
• Job title of "Business, finance and administration occupations":
  {Job title of "Business, finance and administration occupations":105}
• Job title of "Education, law and social, community and government services occupations":
  {Job title of "Education, law and social, community and government services occupations":106}
• Job title of "Health occupations":
  {Job title of "Health occupations":107}
• Job title of "Management occupations":
  {Job title of "Management occupations":108}
• Job title of "Manufacturing and utilities occupations":
  {Job title of "Manufacturing and utilities occupations":109}
• Job title of "Military/armed forces":
  {Job title of "Military/armed forces":110}
• Any other valid Passport/Identity Certificate (IC) held:
  {Any other valid Passport/Identity Certificate (IC) held:31}
• Job title of "Natural and applied sciences and related occupations":
  {Job title of "Natural and applied sciences and related occupations":111}
• Job title of "Natural resources, agriculture and related production occupations":
  {Job title of "Natural resources, agriculture and related production occupations":112}
• Job title of "Sales and service occupations":
  {Job title of "Sales and service occupations":113}
• Job title of "Trades, transport and equipment operators and related occupations":
  {Job title of "Trades, transport and equipment operators and related occupations":114}
• Name of employer or school, as appropriate:
  {Name of employer or school, as appropriate:115}
• Country/territory:
  {Country/territory:117}
• City/town:
  {City/town:116}
• Since what year?
  {Since what year?:118}

Contact Information

• Email:
  {Email:83}

Residential address

• Apartment/unit number (if applicable):
  {Apartment/unit number (if applicable):85}
• Street/civic number or house name:
  {Street/civic number or house name:86}
• Street address/name:
  {Street address/name:87}
• Street address/name line 2 (if applicable):
  {Street address/name line 2 (if applicable):88}
• City/town:
  {City/town:89}
• Country/territory:
  {Country/territory:90}
• District/region:
  {District/region:91}

Travel information

• Do you know when you will travel to Canada?
  {Do you know when you will travel to Canada?:93}
• When do you plan to travel to Canada?
  {When do you plan to travel to Canada?:94}
• Please enter the time your flight to Canada will depart:
  {Please enter the time your flight to Canada will depart:95}

Background Questions

• Have you ever been refused a visa or permit, denied entry to, or ordered to leave Canada or any other country/territory?
  {Have you ever been refused a visa or permit, denied entry to, or ordered to leave Canada or any other country/territory?:123}
• For each refusal, please indicate the country that refused you a visa or permit, or denied you entry, as well as the reasons provided to you by the country.
  {For each refusal, please indicate the country that refused you a visa or permit, or denied you entry, as well as the reasons provided to you by the country.:128}
• Have you ever committed, been arrested for, been charged with or convicted of any criminal offence in any country/territory?
  {Have you ever committed, been arrested for, been charged with or convicted of any criminal offence in any country/territory?:124}
• For each arrest, charge, or conviction, please indicate where (city, country), when (month/year), the nature of the offence, and the sentence.
  {For each arrest, charge, or conviction, please indicate where (city, country), when (month/year), the nature of the offence, and the sentence.:129}
• In the past two years, were you diagnosed with tuberculosis or have you been in close contact with a person with tuberculosis?
  {In the past two years, were you diagnosed with tuberculosis or have you been in close contact with a person with tuberculosis?:125}
• Is your contact with tuberculosis the result of being a health care worker?
  {Is your contact with tuberculosis the result of being a health care worker?:130}
• Have you ever been diagnosed with tuberculosis?
  {Have you ever been diagnosed with tuberculosis?:131}
• Do you have one of these conditions?
  {Do you have one of these conditions?:126}
• Please briefly indicate if there are additional details pertinent to your application. For example, an urgent need to travel to Canada. Provide relevant details to avoid delays in the processing of your application.
  {Please briefly indicate if there are additional details pertinent to your application. For example, an urgent need to travel to Canada. Provide relevant details to avoid delays in the processing of your application.:127}

Consent and declaration

• I Agree with "Consent and declaration" and "Declaration of Applicant":
  {I Agree with "Consent and declaration" and "Declaration of Applicant":97}
• Signature of applicant:
  {Signature of applicant:98}