Secure Delegate Form

First Name

Middle Name

Last Name

Date of Birth

Passport #

Passport – Date of issue

Passport – Date of expiry

Passport – Data page

CV/Resume

Company/Organization represented

Position in Company/Organization

Proof of Financial Support: 1. Bank statements (last 4-6 months)

Proof of Financial Support: 2. Pay stubs from work last 2 months

Proof of Financial Support: 3. Employment letter showing salary and length of employment as well as job description and duties outlined in the letter

Proof of Ties to Home Country: 1. Job confirmation

Proof of Ties to Home Country: 2. Property ownership

Proof of Ties to Home Country: 3. Family connections

Proof of Ties to Home Country: 4. Financial assets

Additional Documents: Marriage license/certificate (if applicable) or any other documents required by the visa office for your region

Have you ever applied for a Canadian visa before?

Yes No

Why was the visa application denied? State why.

Conference Registration Fee Payment Receipt

Company/Organization address

Your telephone number (no spaces or dashes)

Your email

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