Trades, Engineering Occupations and Post-Graduate Workers Application for Nomination (AINP 009B)

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1 Trades, Engineering Occupations and Post-Graduate Workers Application for Nomination (AINP 009B) Strategic Recruitment Stream The personal information provided on this form and attachments is collected under the authority of section 33(c), and managed in accordance with the Freedom of Information and Protection of Privacy Act. The information will be used for the purpose of administering the Alberta Immigrant Nominee Program. If you have any questions about the collection of this information, you can contact the Alberta Immigrant Nominee Program, Suite 940, ATB Place North Tower, Jasper Avenue, Edmonton, Alberta, Canada, T5J 1S6. Fax: A. Candidate Details File Number (office use): Candidate's family name: Candidate's given name(s): Candidate's Gender: Candidate's residential address: Prov. / Terr. / State: Postal / Zip code: Country: Canada Candidate's mailing address: (check here if same as above) Prov. / Terr. / State: Postal / Zip code: Country: Candidate's home phone: Candidate's cell phone: Candidate's work phone: Candidate's fax: Candidate's Candidate's date of birth:(yyyy/mm/dd) Language of Communication: English French Candidate's country of citizenship: Native Language Candidate's country of birth: B. Citizenship and Immigration Canada (CIC) Application History Candidate's place of birth: (city or town) Candidate's intended province or territory of residence in Canada: Have you, your spouse/common-law partner, or any of your dependent children, already submitted an application for permanent residence in Canada to Citizenship and Immigration Canada (CIC)? Yes No If Yes, respond to each of the following: Canadian visa office to which application for permanent residence was already submitted: Date application submitted: (yyyy/mm/dd) Status of application: CIC File Number: Principal applicant: Intended province or territory of residence on CIC application: Other Application class/category: Application class/category: Page 1 of 7

2 C. Candidate's Occupation and Education Current job title: Name of Employer: Current wage or salary: Hourly Annual $ CAD Candidate s address of employment: Prov. / Terr. / State: Postal / Zip code: Country: Current four-digit National Occupational Classification (NOC) code: To determine your NOC code visit: Education History Do you have any formal education? Yes No Total years of education: Level of education successfully completed: (check all that apply) Doctorate / PhD Master's Degree Bachelor's Degree Diploma (2 years) Certificate (1 year) Trade Certification/Apprenticeship Secondary school Other: (specify) Industry and Association Standards required and obtained: Alberta Apprenticeship and Industry Training (AIT) Journeyperson Certification College of Physicians and Surgeons of Alberta College and Association of Registered Nurses of Alberta (CARNA) Association of Professional Engineers and Geoscientists of Alberta (APEGA) emerit Professional Certification Certification in Workplace Hazardous Materials Information System (WHMIS) Other standards required and obtained (specify below): Work History Total years of employment: List all employment since age 18 that is relevant to the occupation/noc code for which you are submitting this application: (add extra lines if necessary) From (date): (yyyy/mm) To (date): (yyyy/mm) Name of employer: Occupation: City: Country: From (date): (yyyy/mm) To (date): (yyyy/mm) Name of employer: Occupation: City: Country: From (date): (yyyy/mm) To (date): (yyyy/mm) Name of employer: Occupation: City: Country: Page 2 of 7

3 D. Family Members Are you including a spouse or common-law partner who will accompany you to Canada? (do not include Canadian Citizens or permanent residents) Yes No Spouse or common-law partner Family name: Given name: Date of birth: (yyyy/mm/dd) Gender: Candidate's Spouse/Common-Law Partner's Occupation and Education Current job title: Number of years worked in Canada: Education History Do you have any formal education? Yes No Years of formal education: Level of education successfully completed: (check all that apply) Doctorate / PhD Master's Degree Diploma (2 years) Certificate (1 year) Secondary school Other: (specify below) Bachelor's Degree Trade Certification/Apprenticeship Are you including any dependent children who will accompany you to Canada? (Please refer to the CIC's website for the current definition of dependent. Do not include Canadian Citizens or permanent residents) Yes No Dependant Dependant Dependant Family name: Given name: Date of birth: (yyyy/mm/dd) Gender: E. Background in Canada and Alberta List each person living in Canada who is related to you or your spouse/common-law partner: (add extra lines if necessary) Name of Relative: Relationship: Province / Territory: Years spent in Canada: Name of Relative: Relationship: Province / Territory: Years spent in Canada: Page 3 of 7

4 Name of Relative: Relationship: Province / Territory: Years spent in Canada: List any visits you have made to Canada, before you completed this form, where you had entered and then departed: (add extra lines if necessary) Reason for visit: Province / Territory visited: Year/Month entered: (yyyy/mm) Year/Month departed: (yyyy/mm) Reason for visit: Province / Territory visited: Year/Month entered: (yyyy/mm) Year/Month departed: (yyyy/mm) Reason for visit: Province / Territory visited: Year/Month entered: (yyyy/mm) Year/Month departed: (yyyy/mm) F. Document Checklist The document checklist specific to this category can be found on our website: AINP Compulsory and Optional Trades or Engineering Occupations Category: AINP SRS Post-Graduate Worker Category: I have attached all required and supporting document outlined in the document checklist: Yes No G. Marketing How did you learn about the AINP? (check all that apply) Alberta promotional material AINP website Family member Immigrate to Alberta Information Service Recruitment agency Alberta government webinar Other: (specify below) H. Program Evaluation AINP will be contacting you in the future for follow-up. Please provide the name of an additional contact person, preferably in Canada, who we may contact if we cannot reach you. Do not list your authorized representative, your spouse/common-law partner or your employer. Family Name: Given Name(s): Phone number of contact person: of contact person: Page 4 of 7

5 I. Use of a Representative I have used a representative or third party in connection with this application to the AINP. Yes No If the answer is "yes", the Candidate must complete the Candidate - Use of a Representative (AINP 008B) form, (if this was not already done), which can be found on our website: Page 5 of 7

6 J. Declaration and Authorization of Candidate By signing and submitting this form, I confirm that: 1. The information I have provided in this application is true, complete and correct and I, the candidate, have personally provided it. 2. I understand that: a. the availability of AINP streams and categories is dependent on application volumes and labour market needs. AINP streams and categories may be closed or suspended without prior notice. The AINP reserves the right to close application intake for any AINP stream or category at any time, without prior notice. Further, the AINP may decline to consider applications to closed or suspended streams or categories, regardless of when the applications were submitted. Changes to the AINP, including notice of suspension or closure of its streams and categories are available on the AINP News Page ( and/or the AINP Application Forms page (www. albertacanada.com/opportunity/immigrating/ainp-application-forms.aspx). b. the AINP is not obligated to assess/process any applications submitted. Applications to the AINP are treated as an expression of interest, and as such, will be processed according to quality of the application (completeness, eligibility), labour market information, occupational supply and demand forecasting, AINP application volumes, and / or any other factors at the AINP S discretion. By submitting an application to the AINP I acknowledge and agree that my application may not be processed in the order received, or at all. Further, the decision to assess / process any particular application, and the outcome of any such assessment / processing, is at the AINP S sole discretion. Program criteria are eligibility minimums, and meeting program criteria does not guarantee that my application will be assessed, processed, or granted. 3. I understand that submitting an Application for Permanent Residence in Canada to Citizenship and Immigration Canada on the basis of an Alberta Immigrant Nominee Program (AINP) Nomination issued by the Government of Alberta, is subject to federal requirements. Specifically, my application for permanent residence is subject to the statutory requirements for admissibility under the Immigration and Refugee Protection Act and its Regulations, and the Nomination and application do not guarantee that I will be granted permanent residence in Canada. 4. I understand that the AINP may decline this application or withdraw a Nomination: a. If I have submitted any false statements or concealed a relevant or significant fact. Both constitute misrepresentation; b. If I do not comply with any request for information required by the AINP to effectively administer and maintain the integrity of the program; c. For reasons other than the above statements. As a result of this decline or withdrawal, the AINP may refuse to consider me as a Candidate for Nomination for an unspecified period. 5. I understand all of the above statements, and have asked for and received an explanation, or language translation if required, on every point about which I may have been uncertain. 6. I intend to reside and work in Alberta on a permanent basis. K. Candidate's Authorization to Collect and Disclose Personal Information By signing and submitting this form: 1. I acknowledge that the AINP will disclose, as necessary, information collected from this application under the program, to officials in the Government of Alberta, including but not limited to partner ministries, and to officials administering immigration, temporary foreign worker or other programs related to permanent residence or temporary residence within the Government of Canada. 2. I acknowledge that the Government of Canada will disclose, as necessary, personal information about me collected under the Immigration and Refugee Protection Act and its Regulations to officials administering the AINP. I also acknowledge that the AINP will collect such information. 3. I acknowledge that the AINP will disclose, as necessary, personal information collected from this and any other application received by the AINP to third party evaluators used under contract by the AINP. I understand that the third party used by the AINP will confirm my qualifications and background. The information provided to the third party evaluator will be shared with their worksites in the required countries to perform this service on behalf of the AINP. 4. I acknowledge that the AINP and/or AINP's third party evaluator will contact previous institutions or employers I have identified to verify my background and eligibility for the AINP, and I authorize the AINP to collect such information. 5. I authorize my current and past employers to provide details of my employment to the AINP and authorize the AINP to collect such information. 6. I confirm my understanding of all the previous statements, and have asked for and received an explanation, or language translation if required, of every point that was not clear to me. 7. I consent to be contacted to complete brief questionnaires to evaluate the program should I become a permanent resident as an Alberta Provincial Nominee, as required by Citizenship and Immigration Canada. I understand that a third party may be used to administer these questionnaires. Candidate Authorization Original signatures are required on the application in blue ink. Candidate's name (print) Signature (candidate) Spouse's or common-law partner's name (print) Signature (spouse or common-law partner) Dependent child's name, 18 years of age or older (print) Signature (dependant) Page 6 of 7

7 Dependent child's name, 18 years of age or older (print) Signature (dependant) Date signed (yyyy/mm/dd) Page 7 of 7

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