Morden Community Driven Immigration Initiative

By applying to the Morden Community Driven Immigration Initiative, you are applying for Morden’s support for your
future application to the Manitoba Provincial Nominee Program. It is your responsibility to ensure that you meet and
continue to meet the criteria of the MPNP. Please see www.mordenimmigration.com for criteria.

Submission Date: (MM/DD/YYYY)______/______/______

1) Contact Information
Address: _____________________________________________________________________________

Phone:__________________ Email:___________________ Skype Address: __________________

Federal Express Entry Number: ________________________________ (this application will NOT be evaluated or kept
without this number AND a scan of the letter showing you have been accepted into the Federal Express Entry Pool).
Exception: Welders, Carpenters or those with strong French language ability.
Full Legal Name of PRINCIPAL APPLICANT: __________________
Date of Birth: (MM/DD/YYYY)______/______/_______ Country of Birth: __________________

Gender: Male Female

Language test score (IELTS/CELPIP or TEF/TCF) ________________

Full Legal Name of SPOUSE: __________________
Date of Birth: (MM/DD/YYYY)______/______/_______ Country of Birth: __________________

Gender: Male Female

Language test score (IELTS/CELPIP or TEF/TCF) (not required for spouse)________________

DEPENDENT CHILDREN (if applicable) (see http://www.immigratemanitoba.com/apply-to-mpnp/family/ for definition

of dependent children).
Birthdates:
(MM/DD/YYYY)
Child #1 Child #2 Child #3 Child #4 Child #5

2) Connection to Canada

a)Please indicate all the parts of Canada you have family, friends or associates (Associates are people you do not
know personally or may have never met – for example friends of friends)
No family, friends or associates in Canada
Family Friends Associates Where do they live? (City/Province)
In Morden area

Other parts of Manitoba

Other parts of Canada

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If family, what is the relationship? Please specify: _____________________

How long have the above friends or family been in Canada? If they are in Manitoba, are they able to support your
application directly to the MPNP? _____________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

3) Available Settlement Funds

a) The Provincial Nominee Program (MPNP) requires that applicants have sufficient settlement funds
available when they move to Manitoba. Settlement funds and other assets must be only in the name of the
principal applicant or spouse.

Please List IN CANADIAN EQUIVILENT funds:

Cash / Account: $_________
House / Apartment Value: $_________
Other: $_________

4) Education and Employment

a) What type/field of employment would you be most interested in gaining on arrival to Morden?

Declared NOC code of Principal applicant _________________________________________________________

(see http://noc.esdc.gc.ca/English/NOC/NewNOC.aspx?ver=16)

Principal Applicant:_________________________________________________________________________________
Spouse:___________________________________________________________________________________________

b) Education of Principal Applicant - Give full details of all education (including secondary/high school,
university/college/apprenticeship training).

From: To: Name of Institution City and Country Type of certificate

Year/Month Year/Month or diploma issued

c) Education of Spouse - Give full details of all education (including secondary/high school,
university/college/apprenticeship training).

From: To: Name of Institution City and Country Type of certificate

Year/Month Year/Month or diploma issued

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 d) Work History of Principal Applicant - Give full details of all work history

From: To: Occupation/Job Type of Compny Name of company,

Year/Month Year/Month Title --e.g. (manufacturing, employer, school,
healthcare facility

e) Work History of Spouse - Give full details of all work history

From: To: Occupation/Job Type of Compny Name of company,

Year/Month Year/Month Title --e.g. (manufacturing, employer, school,
healthcare facility

5) Application History and Travel History

a) Have you ever worked or studied outside of your home country (including Canada)? Yes No

Years Province/Country Purpose/Type of

Training/Job

b) If invited to take part in our program, you will be required to come to Morden for an exploratory visit. Have you
ever applied for a travel visa to Canada? Yes No
If yes:
Year:________________________ Purpose:____________________________

Result:______________________________________________________________________________________

c) Has an immigration application ever been submitted for principal applicant or dependents for:
i) Morden’s Community Driven Immigration Initiative? Yes No

ii) Manitoba Provincial Nominee Program: Yes No

iii) Any other Provincial Nominee Program? Yes No

iv) Federal or any other Canadian Immigration Program? Yes No

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For ALL previous applications above, please answer ALL of the following – 1) Who was the Principal Applicant? 2) When
was the application submitted? 3) Has the application been denied? 4) Why was the application denied? 5) How has this
situation changed?

6) Other Information

a) Please indicate the services, characteristics, facilities, and other qualities that are important to have in a new
community to meet the needs of you and your family. Why do you feel that Morden will meet your needs?

b) Please indicate how you learned about the following Morden Community Driven Immigration:
Consultant, please identify the consultant_______________________________________

Website, please identify the website____________________________________________

Family/Friend referral, please specify where they live______________________________

Other, please specify________________________________________________________

c) Attachments required for this application:

Scan of signed pages of this application

C.V. or resume for all persons 18 years and over

Scanned copy of principal applicant’s IELTS results

Scanned copy of principal applicant’s passport

Scanned copy of Bank statement proving adequate settlement funds

Scan of the letter showing you have been accepted into the Federal Express Entry Pool

Educational Equivalency document (ex. WES, IQAS) (for express entry applicants)

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Please do not include education documents or certificates, reference letters, or other such documents.
d) If you did not complete your own application, please provide the contact information of the person(s) or agency
that completed this application:

Name:______________________________ ICCRC ID number:________________________________

Email: ______________________________ Phone: __________________________________________

Authorization to Disclose
I/We,__________________________________, do hereby authorize the Morden Community Development Corporation
staff to enquire with the Provincial Nominee Program (MPNP) staff regarding my/our potential application to the MPNP
for the purposes of determining my eligibility under the Morden Community Driven Immigration Initiative. We hereby
authorize the sharing of information between both parties for the purposes indicated above. We also consent to having
direct contact with an authorized representative of the Morden Community Development Corporation for the purposes of
discussing our application to the Morden Community Driven Immigration Initiative, and understand this contact is likely
to be by telephone and email. We also consent to having our C.V. / resume and related information shared with select
Morden Employers with the purpose of potential job possibilities.

I/We understand that:

• This consent is given for the stated purposes and for no other purpose without my/our written consent.
• This consent includes my/our dependents
• I/We may change or cancel this authorization at any time except for such action as has already been taken.

Principal Applicant Name (print)____________ Signature: ____________ Date: ____________

Spouse (if applicable) Name (print)____________ Signature: ____________ Date: ____________

I verify that the information provided in this application is correct and true to the best of my knowledge. I also
acknowledge that any misrepresentation of information may result in my application being declined and I may not be able
to participate in this initiative now or in the future.

Principal Applicant Signature Principal Applicant (Name in Print) Date

By completing this application, you are declaring your intention to live, work, and settle in Morden, if you arrive in Canada
through the support of Morden’s Community Driven Immigration Initiative.

Please send completed forms to: Immigration@mymorden.ca

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