Discloser - Immigration Beta

Within the past two years, have you or a family member ever had tuberculosis of the lungs or been in close contact with a person with tuberculosis?

Yes No

Do you have any physical or mental disorder that would require social and/or health services, other than medication, during a stay in Canada?

Yes No

Have you ever remained beyond the validity of your status, attended school without authorization or worked without authorization in Canada?

Yes No

Have you ever been refused a visa or permit, denied entry or ordered to leave Canada or any other country or territory?

Yes No

Have you previously applied to enter or remain in Canada?

Yes No

Have you ever committed, been arrested for, or been charged with or convicted of any criminal offence in any country or territory?

Yes No

Did you serve in any military, militia, or civil defence unit or serve in a security organization or police force (including non obligatory national service, reserve or volunteer units)?

Yes No

Are you, or have you ever been a member or associated with any political party, or other group or organization which has engaged in or advocated violence as a means to achieving a political or religious objective, or which has been associated with criminal activity at any time?

Yes No

Have you ever witnessed or participated in the ill treatment of prisoners or civilians, looting or desecration of religious buildings?

Yes No

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