ETA Canada Visa » Application EN

Traveler identity

Sex*

Last Name*

First Name*

Date of birth*

Country of birth*

Place of birth*

Email*

Email confirmation*

Marital status *

Are you applying on behalf of a minor child? *

Your contact details

Country code*

Phone number*

Home address

Address NO*

Address*

Postal code*

City*

Country*

Your passport

Passport number*

Passport number cofirmation*

Country of citizenship*

Country of issue*

Date of issuance*

Date of expiry*

If you enter the wrong passport number OR country code, you may be prohibited from boarding your flight to Canada.

You will only find out at the airport that you have made a mistake.
You will need to re-apply for an eTA.
Depending on your situation, you may not be able to get an eTA at the last minute.

Votre voyage

Have you ever applied for a visa, eTA or permit to visit, live, work or study in Canada?*
Yes No

Do you know when you are going to Canada?*
Yes No

When do you intend to travel to Canada?*

If you do not yet know the date of your trip, indicate an approximate date.

Request validation

1. Have you ever been refused a Visa or permit, prohibited from entering Canada or any other country or territory, or asked to leave Canada or any other country or territory?*
Yes No

2. Have you ever committed a criminal offense in any country or territory, or have you ever been arrested for such an offense, charged with or found guilty of such an offense?*
Yes No

3. In the past two years, have you been diagnosed with tuberculosis or have you been in contact with someone with tuberculosis?*
Yes No

4. Do you have any of these medical conditions?*

·  I declare that the information I have provided in this request is true, complete and correct.
·  I recognize that by clicking on "Validate", I sign this request electronically.
·  I know that making a false statement is a violation of section 127 of the Immigration and Refugee Protection Act and can lead to inadmissibility to Canada or removal from Canada.

I accept the terms and conditions