Morden Community Driven Immigration Initiative

-Business Interest Information Form-

This purpose of this form is to assist Morden’s Community Development Corporation in determining whether your
background and business interest is a potentially successful fit for the City of Morden.

Submission Date: (M/D/Y)

1) Contact Information

Address:
Email:

Full Legal Name of PRINCIPAL APPLICANT:

Date of Birth: (M/D/Y) Country of Birth: Gender: Male Female

English Test Score: IELTS (International English Language Testing System, www.ielts.com )
If no IELTS test please check: No/little English/French language proficiency

Moderate proficiency, can communicate well in most situations

Higher language proficiency, fluent

Full Legal Name of SPOUSE (if applicable):

Date of Birth: (M/D/Y) Country of Birth: Gender: Male Female

English Test Score: IELTS (not required for spouse)

If no IELTS test please check: No/little English/French language proficiency

Moderate proficiency, can communicate well in most situations

Higher language proficiency, fluent

Current Occupation of SPOUSE (if applicable):

DEPENDENT CHILDREN (if applicable)

Birthdates: Child #1 Child #2 Child #3 Child #4 Child #5
(M/D/Y)

2) Net Worth:Total Net Worth of applicant and spouse combined (must be only in the name of self and/or
spouse):

$500,000 to $ $1 Million CDN

Above $1 Million to $1.5 Million
Above $1.5 Million to $2 Million
Above $2 Million to $2.5 Million
Above $2.5 Million

Total Liquid funds of applicant and spouse combined (included in above)

<$100,000 CDN
$100,000 - $250,000 CDN
$250,000 - $500,000
$500,000 - $1 Million
Morden Community Development Corporation, Morden, MB, Canada Email: info@mordenimmigration.com
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 Morden Community Driven Immigration Initiative
-Business Interest Information Form-

Above $1 Million

3) Application History and Travel History – a( have you ever worked, studied, or travelled in Canada?
Years Province Purpose/Type of Training/Job

b) Has an immigration application ever been submitted for principal applicant or dependants 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
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?

4) Other
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
If family, what is the relationship? Please specify

b) Please give a brief overview of the type of business that you would be interested in investing in or starting
in Morden

Morden Community Development Corporation, Morden, MB, Canada Email: info@mordenimmigration.com

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 Morden Community Driven Immigration Initiative
-Business Interest Information Form-

c) How did you learn about Morden’s Immigration Initiative?

d) Please enter work/business history: Add additional info on separate page if necessary.
Start date End date Company Position Percentage If own If own
ownership business, business,
average average
yearly sales number of
employees

Please enclose a CV for principal applicant

e) A consultant is not required for any stage of your application process. However, if you have or plan to
hire a consultant to assist you, please provide the contact information of the person(s) or agency that
completed this application.
Name: ICCRC ID number:
Email:
________________________________________________________
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 individuals in Morden to assist with the planning process.

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: __________

Morden Community Development Corporation, Morden, MB, Canada Email: info@mordenimmigration.com

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 Morden Community Driven Immigration Initiative
-Business Interest Information Form-

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

Morden Community Development Corporation, Morden, MB, Canada Email: info@mordenimmigration.com

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