Application to Change Conditions, Extend my Stay or Remain in Canada as a Worker (IMM 5710)
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Application to Change Conditions, Extend my Stay or Remain in Canada as a Worker [IMM 5710] (PDF, 0.6 MB)
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Application to Change Conditions, Extend my Stay or Remain in Canada as a Worker (IMM 5710)
Who must fill out this application form?
This form must be completed by each person who wants to apply for an extension of their work permit or change conditions of their stay in Canada, including applying for an initial work permit.
Completing the form
You must answer all the questions on this application form unless indicated otherwise.
Download and fill out the application form on a computer.
You also have the option of saving your form and completing it later.
Note: Completing the form electronically is easier and reduces the risk of errors that can slow down the application process.
In order to help you fill out the application form, read and follow the steps below.
- Question 1
-
Type your Unique Client Identifier number (UCI).
Note: The UCI or Client ID can be found on your study or work permit under the section “Country of Citizenship”.
- Question 2
-
From the list, select the language (English or French) in which you would like to receive your service.
- Question 3
-
Check the appropriate box or boxes to indicate if you are applying for:
- A work permit with the same employer
- An initial work permit or a work permit with a new employer
- Restoration of your status as a worker
- An initial or an extension of a temporary resident permit
Personal details
- Question 1
-
Full name
Type your family name (surname) as it appears on your passport or travel document (even if the name is misspelled). Do not use initials.
Note: If you do not have a family name on your passport or travel document, enter all your given names here and leave the given name field blank.
Type all of your given names (first, second, or more) as they appear on your passport or travel document (even if the name is misspelled). Do not use initials.
Note: If you do not have a given name on your passport or travel document, leave this field blank. Do not enter “*”, “Not applicable” or “NA”.
- Question 2
-
Nicknames / Alias
Check the box to indicate if you ever used any other name. This could include your birth name, maiden name, married name, nickname, etc.
If you checked “Yes”, type any other family name that you have ever used.
If you checked “Yes”, type any other given name (first, second, or more) that you have ever used.
- Question 3
-
From the list, select your gender (F-Female, M-Male or X-Another gender).
Note: If you choose a gender identifier that is different than what you currently have or have had on your Canadian temporary resident document (visa, electronic travel authorization, work permit, study permit or visitor record), you need to complete the Request for a Change of Sex or Gender Identifier form and send it with your application. If you’ve never had a Canadian temporary resident document but you intend to apply for one and you identify with a gender that is different than what appears on your foreign travel document or passport, you also need to complete the Request for a Change of Sex or Gender Identifier form and send it with your application. No supporting documents are required.
- Question 4
-
Indicate your date of birth. If your complete date of birth is unknown, please use “*” (star sign/asterisk) to fill in the spaces for the year, month or day, where applicable.
- Question 5
-
Type your city or town of birth.
From the list, select your country of birth.
- Question 6
-
From the list, select your country of citizenship. To be a citizen of a country means that you were either born in that country (in most cases) or have been granted citizenship by that country. If you have dual citizenship, select the country that issued the passport you will be using for this trip.
- Question 7
-
From the list, select the appropriate information to indicate your immigration status in Canada:
- Citizen
- Permanent resident
- Visitor
- Worker
- Student
- Other
- Protected Person
- Refugee Claimant
- Foreign National
Other: This section must be completed if you selected “Other” as a status.
Provide the dates (From-To) to indicate how long you have had this status.
For out-of-status applicants:
- Under “Status” select “Other”;
- Under “Other” type in “Out of status, requires restoration”;
- Leave the “From” and “To” boxes blank.
- Question 8
-
Check the box to indicate whether you have lived in any country other than your country of citizenship or your current country of residence for more than six (6) months in the past five (5) years.
If you checked “Yes”, from the list select the appropriate information to indicate the following:
- The name of the country you lived in,
- Your immigration status for the time you
were in that country:
- Citizen
- Permanent resident
- Visitor
- Worker
- Student
- Other
- Protected Person
- Refugee Claimant
- Foreign National
- Other: This section must be completed if you selected ‘Other’ as a status,
- The dates (From – To) you were living in that country.
- Question 9
-
- From the list, choose your current marital
status:
- Annulled Marriage: This is a marriage that is legally declared invalid. An annulment can also be a declaration by the Catholic Church that the marital union did not have a binding force.
- Common-Law: This means that you have lived continuously with your partner in a marital-type relationship for a minimum of one year.
- Divorced: This means that you are officially separated and have legally ended your marriage.
- Legally Separated: This means that you are married, but no longer living with your spouse.
- Married: This means that you and your spouse have had a ceremony that legally binds you to each other. Your marriage must be legally recognized in the country where it was performed and in Canada.
- Single: This means that you have never been married and are not in a common-law relationship.
- Widowed: This means that your spouse has died and that you have not re-married or entered into a common-law relationship.
- Enter the date (year, month and day) you were married or you entered into your current common-law relationship.
- Type the family names and given names of your current spouse or common-law partner.
- Check “Yes” or “No” to indicate if your spouse or common-law partner is a Canadian citizen or a permanent resident.
Note: If you are in a common-law union, you must also complete the Statutory Declaration of Common-law Union (IMM 5409) (opens in a new tab) form and include it with your application. If you are married, you must provide a photocopy of your Marriage license or certificate with your application.
- From the list, choose your current marital
status:
- Question 10
-
Check the box to indicate whether you have previously been married or in a common-law relationship. If you checked “Yes”, provide the:
- Family name(s),
- Given names,
- Type of relationship:
- Common-law, or
- Married.
- Dates (From-To) for which you were in the relationship with your previous spouse or common-law partner,
- Date of birth
Language
- Question 1
-
- From the list, select your first (native)
language. This is the language that
you learned at home during your
childhood and which you still
understand.
Note: If your native language does not appear in this list, select “other”.
- If your native language is not English or
French, write which one you use
mostly:
- English
- French
- Neither
- From the list, select your first (native)
language. This is the language that
you learned at home during your
childhood and which you still
understand.
- Question 2
-
From the list, select whether you are able to communicate in English, French or both:
- English
- French
- Both
- Neither
- Question 3
-
Check Yes or No to indicate if you have taken a test from a designated testing agency to assess your proficiency in English or French.
Passport
- Question 1
-
Type your valid passport or travel document number exactly as indicated on your document. Make sure there is no space between each number or letter.
- Question 2
-
From the list, select the name of the country or territory that issued your passport or travel document.
- Question 3
-
Enter the date your passport or travel document was issued.
- Question 4
-
Enter the date your passport or travel document will expire.
- Question 5
-
For this trip – Check Yes or No to tell us if you are using a passport issued by the Ministry of Foreign Affairs in Taiwan that shows your personal identification number.
- Question 6
-
For this trip – Check Yes or No to tell us if you are using a National Israeli passport.
National Identity Document
- Question 1
-
Check Yes or No to tell us if you have a national identity document.
- Question 2
-
Enter your national identity document number exactly as shown on the document.
- Question 3
-
From the list, select the name of the country or territory that issued your national identity document.
- Question 4
-
Enter the date your national identity document was issued.
- Question 5
-
Enter the date your national identity document will expire.
US PR Card
- Question 1
-
Check Yes or No to tell us if you are a lawful permanent resident of the United States with a valid alien registration card (green card).
- Question 2
-
Enter your valid alien registration card (green card) document number exactly as shown on the document.
- Question 3
-
Enter when your alien registration card (green card) document will expire.
Contact information
- Question 1
-
Indicate your current mailing address (where information should be mailed) by typing the following information:
- Post Office Box (P.O. Box) number, if applicable. If you do not indicate post office box number, the Street number must be provided.
- Apartment (Apt.) or Unit, if applicable
- Street number (No.), if applicable. This must be provided if you did not type in a P.O. Box number
- Street name, if applicable. Do not abbreviate words (Street, Avenue, Boulevard, Drive, etc.) except for directions (NW, SE, W, etc.).
- City or Town
- Province
- Postal code
Note: All correspondence will go to this address unless you indicate your e-mail address.
If you wish to have a representative who can conduct business on your behalf, you must provide their email and mailing address in this section and on the Use of a Representative (IMM 5476) form.
- Question 2
-
Check the box to indicate whether your residential address (where you live) is the same as your mailing address. If "No", type the following information:
- Apartment (Apt.) or Unit, if applicable
- Street Number (No.)
- Street Name. Do not abbreviate words (Street, Avenue, Boulevard, Drive, etc.) except for directions (NW, SE, W, etc.);
- City or Town
- Country
- Province
- Postal Code
- Question 3
-
Check the appropriate box to indicate if the telephone number is from Canada/the United States (US) or Other (any other country).
From the list, select the type of telephone:
- Residence (home)
- Cellular (cell/mobile)
- Business (work)
Type your telephone number including the country code, area/regional codes, etc.
If you have an extension number, write it after your phone number under “Ext.”
- Question 4
-
Check the appropriate box to indicate if your additional telephone number is from Canada/the United States or Other (any other country).
From the list, select the type of telephone:
- Residence (home)
- Cellular (cell/mobile)
- Business (work)
Type your telephone number including the country code, area/regional codes, etc.
If you have an extension number, write it after your phone number under “Ext.”
- Question 5
-
Check the appropriate box to indicate if the facsimile (fax) number is from Canada and United States or Other (any other country).
If applicable, type your facsimile (fax) number, including country code, area/regional codes, etc.
- Question 6
-
If applicable, type your e-mail address using a format similar to the following: name@provider.net
Note: Please ensure this email address is checked regularly. Any emails sent to you by CIC will end in “@cic.gc.ca”, or “@canada.ca”, or “@international.gc.ca”. Please add these to your “safe senders” list in your email program and check the junk mail folder in case important emails get filtered. If we find that the email address you provided is not functional or no longer exists, we will communicate with you by mail. By indicating your e-mail address, you are hereby authorizing transmission of correspondence including file and personal information to be sent electronically to you at the address provided.
Coming into Canada
- Question 1
-
Provide the date and the place where you first entered in Canada
- Question 2
-
- Indicate the purpose of your original visit:
- Business
- Tourism
- Study
- Work
- Other (medical visit, transit, etc.)
- Family Visit
- If you choose "Other" in question 1a), provide details.
- Indicate the purpose of your original visit:
- Question 3
-
Provide the date and the place of your recent entry to Canada
- Question 4
-
Provide the document number of your most recent Visitor Record, study or work permit.
Details of intended work in Canada
- Question 1
-
Select the type of work permit you want:
- Co-op Work Permit
- Exemption from Labour Market Impact Assessment
- Labour Market Impact Assessment Stream
- Live-in Caregiver Program
- Open Work Permit
- Open Work Permit for Vulnerable Workers
- Other
- Post-Graduation Work Permit
- Start-up Business Class
Ask your employer if you’re not sure if you should choose
- Labour Market Impact Assessment Stream or
- Exemption from Labour Market Impact Assessment
If you choose “Open Work Permit” or “Post-Graduation Work Permit”, leave questions 2 to 8 blank.
Do not select “Other” unless you’re on the list below.
Who should select “Other”
Choose “Other” only if:
- You would like to remove medical job conditions from a work permit:
- in the same section for 1 b), under “Other,” write that you need the conditions removed (not authorized to work in childcare, primary/secondary school teachings, health service field occupations).
- you’re applying to extend your status in
Canada to work for a
- foreign mission or international organization recognized under the Foreign Missions and International Organizations Act
- foreign government or
- bridge or tunnel authority
Your employer must give you an employment contract or an employment letter including the following information:
- name of employer
- address of employer
- title
- salary
- hours of work
- any other relevant details
Your employer does not need to submit an offer of employment through the Employer Portal. This means you don’t need to provide a labour market impact assessment (LMIA) number or offer of employment (LMIA-exempt) number.
If you choose “Other” in question 1a), tell us which of the options listed above applies to you.
- Question 2
-
- Co-op work permit applicants: write the designated learning institution (your school) as the employer.
- Write the complete address of the Employer whether foreign or Canadian.
- Question 3
-
Provide the location of your employment in Canada:
- Province
- City or Town
- Address
- Question 4
-
Provide the following details about your employment:
- Job title
- Description of duties (role and responsibilities).
- Question 5
-
Provide the dates of your expected employment in the format provided (From – To).
The dates should match the dates in either the
- labour market impact assessment (LMIA)
- offer of employment
- duration allowed in the work permit category, if applying for an open work permit
For example, the “From” and “To” date for a spousal open work permit must match the validity of the principal applicant's permit. For a post-graduation work permit, the validity depends on the program of study completed.
Note: A work permit cannot be issued for a duration that is longer than the validity of your passport
- Question 6
-
Type the seven-digit number of your valid labour market impact assessment (LMIA) or the alpha numeric combination of the offer of employment (LMIA-Exempt) number. This number begins with the letter “A” and is followed by seven numbers.
If you are applying for a co-op or post-graduation work permit this is not required.
- Question 7
-
Provide the following details about your Quebec Acceptance Certificate (CAQ):
- Certificate Number
- Expiry Date
Note: As of August 2, 2018, the CAQ no longer has a written expiry date. You must calculate your expiry date based on your intended work start date plus the duration of your CAQ. For example, if you intend to start working on January 1, 2019 and your CAQ is valid for 24 months, enter December 31, 2020 for the expiry date.
If you are applying for a co-op or post-graduation work permit this is not required
- Question 8
-
Select “Yes” if you have been issued a certificate under the Provincial Nominee program. Otherwise, select “No”.
Education
Check the box to indicate if you have any post-secondary education (including university, college or apprenticeship training).
The following table provides examples of post-secondary education:
- Trade / Apprenticeship
-
Training completed in a specific trade, such as carpentry or auto mechanics.
- Non-university certificate / diploma
-
Training in a profession that requires formal education but not at the university level (for example, dental technician or engineering technician).
- Bachelor’s degree
-
Academic degree awarded by a college or university to those who completed an undergraduate curriculum; also called a baccalaureate. Examples include a Bachelor of Arts, Science or Education.
- Master’s degree
-
Academic degree awarded by a graduate school of a college or university. You must have completed a Bachelor’s degree before a Master’s degree can be earned.
- PhD
-
Highest university degree, usually based on at least three years of graduate studies and a thesis. Normally, you must have completed a Master’s degree before a PhD can be earned.
If you checked “Yes”, provide full details of your highest level of post-secondary education:
- Enter the dates (year and month) you attended the institution,
- Field(s) of study (mechanics, social sciences, medicine, etc.),
- School or Facility name,
- City or Town,
- From the list, select the country, and
- Province or State.
Employment (Work/Occupation)
For co-op and post-graduation work permit applicants: information in this section are not required.
Provide the following information about your employment for the last 10 years. If you are retired, provide the 10 years before your retirement.
- Question 1
-
Current Activity / Occupation
Provide details about your current Activity / Occupation:
- Enter the dates (year and month) you have been working at your occupation,
- The activity/occupation or a brief description of your position. If you do not work, describe what you are currently doing (retired, not working, going to school, etc.),
- Indicate the name of the company or employer or facility where you work,
- City or Town,
- Country,
- Province/State, if applicable.
- Question 2
-
Previous Activity / Occupation
Provide details of your previous Activity / Occupation for the past 10 years. If you are retired, provide the 10 years before your retirement:
Note: If you need more space, print out an additional page of the form, complete this section and submit it with your application.
Background information
All questions in this section must be answered or the application will be considered incomplete and will be returned.
- Question 1
-
Check the box to indicate if:
- you or any of your family members have ever had tuberculosis of the lungs or been in close contact with a person with tuberculosis within the past two years.
- you have any physical or mental disorder that would require social or health services other than medication during your stay in Canada.
- If you checked “Yes” to any of the above questions, provide details and the name of the family member, if applicable.
- Question 2
-
Check the box to indicate if you have ever:
- remained beyond the validity of your status, attended school without authorization or worked without authorization in Canada
- been refused a visa or permit, denied entry or ordered to leave Canada or any other country.
- applied previously to enter or remain in Canada.
- If you checked “Yes” to one of the above questions, provide details.
- Question 3
-
- Check the box to indicate if you have ever:
- committed,
- been arrested for, or
- been charged with or convicted of any criminal offence in any country.
- If you checked “Yes,” provide details.
- Check the box to indicate if you have ever:
- Question 4
-
- Check the box to indicate if you have ever served in any military, militia, civil defence unit, or serve in a security organization or police force (including non-obligatory national service, reserve or voluntary units).
- If you checked “Yes,” provide your dates of service and the countries where you served.
- Question 5
-
Check “Yes” or “No” to indicate if you have ever been a member or associated with any political party, or other group or organization which has engaged in or advocated violence as means to achieving a political or religious objective, or which has been associated with criminal activity at any time.
- Question 6
-
Check “Yes” or “No” to indicate if you have ever witnessed or participated in the ill treatment of prisoners or civilians, looting or desecration of religious buildings.
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