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Client
First Name
Last Name
Middle Name
User Name
Gender
--- Select Gender ---
Female
Male
Other
Contact Information
City
--- Select City ---
Ajax
Aurora
Barrie
Belleville
Bolton
Brampton
Brantford
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Cambridge
East Gwillimbury
Erin Mills
Georgetown
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Halton Hills
Hamilton
King City
Kingston
Kitchener
London
Markham
Milton
Mississauga
Newmarket
Niagara Falls
North Bay
Oakville
Orangeville
Orillia
Oshawa
Ottawa
Peterborough
Pickering
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Sarnia
Thunder Bay
Toronto
Uxbridge
Vaughan
Weston
Whitby
Whitchurch-Stouffville
Street
Apt./Unit No.
Postal Code
Please contact me by :
Phone
Email
I don't have a permanent address OR address is temporary
Demographics
Date of Birth (dd/mm/yyyy)
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2024
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1923
1922
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1920
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1918
1917
1916
1915
1914
1913
1912
1911
1910
Country of Birth
--- Select Country ---
Afghanistan
Aland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
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Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
British Virgin Islands
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Channel Islands
Chile
China
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Faeroe Islands
Falkland Islands (Malvinas)
Fiji
Finland
France
French Guiana
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
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Greenland
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Guinea-Bissau
Guyana
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Holy See
Honduras
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Hungary
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Indonesia
Iran
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Ireland
Isle of Man
Israel
Italy
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Korea (South)
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Laos
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Liberia
Libya
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Lithuania
Luxemburg
Macao
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Madagascar
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Mali
Malta
Marshall Islands
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Mayotte
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Mozambique
Myanmar
Namibia
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Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Norway
Nothern Mariana Islands
Occupied Palestinian Territory
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Saint Helena
Saint Martin (French part)
Saint Pierre and Miquelon
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South African Rep.
Spain
Sri Lanka
St. Barthelemy
St. Kitts and Nevis
St. Lucia
St. Vincent and the Grenadines
Sudan
Suriname
Svalbard and Jan Mayen Islands
Swaziland
Sweden
Switzerland
Syria
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
U.S. Virgin Islands
U.S.A.
Uganda
Ukraine
United Arab Emirates
United Kingdom of Great Britain
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Wallis and Futuna islands
Western Sahara
Yemen
Zambia
Zimbabwe
First Language
--- Select Language ---
!Kung
!Xóõ
Abkhaz
Abron
Acehnese
Achuar-Shiwiar
Adyghe
Afar
Afrikaans
Aguaruna
Agul
Ajyíninka Apurucayali
Akan
Akhvakh
Aklanon
Albanian
Altay
Alur
Amharic
Amis
Ancash Quechua
Anyi
Arabic
Aragonese
Arakanese
Armenian
Aromanian
Arrernte
Asháninka
Assamese
Assyrian
Atayal
Avar
Awngi
Aymara
Azande
Azerbijani
Bachajón Tzeltal
Bai
Bakoko/Bakole
Balinese
Balochi
Bambara
Bangala
Baoulé
Bari
Bashkir
Basque
Batak
Beja
Belarusian
Bemba
Bengali
Betawi creole
Beti-Pahuin
Bhili
Bhojpuri
Bikol
Bini
Bora
Brahui
Breton
Buginese
Bulgarian
Bunun
Burmese
Buryat
Buyei
Candoshi-Shapra
Cantonese/Yue Chinese
Carolinian
Cashibo-Cacataibo
Cashinahua
Catalan
Cebuano
Central Alaskan Yup'ik
Central Aymara
Central Huasteca Nahuatl
Central Morocco Tamazight (Berber)
Chamorro
Chamula Tzotzil
Chayahuita
Chechen
Cherokee
Chichewa (Nyanja)
Chickasaw
Chiga
Chin
Chipaya
Chiripá
Chokwe
Chukchi
Chuvash
Comanche
Cook Islands Maori
Corsican
Cree
Culina
Czech
Dagaare
Dagbani
Danish
Dargin
Dhivehi / Mahl
Dinka
Dogri
Dolgan
Dong
Dutch
Eastern Bolivian Guaraní
Eastern Huasteca Nahuatl
Ebira
Edo
Enets
English
Erzya
Esperanto
Estonian
Evenki
Ewe
Faroese
Fiji Hindi
Fijian
Finnish
Fon
Franco-Provençal
French
Friulian
Fula/Fulfulde
Galician
Gan
Garhwali
Garifuna
Gbaya
Georgian
German
Gikuyu
Gilaki
Gilbertese
Godoberi
Gogo
Gondi
Greek
Guarani
Gujari
Gujurati
Gusii
Gwari
Haitian Creole
Hakha-Chin
Hakka
Hausa
Haya
Hebrew
Hererro
Highland Puebla Nahuatl
Highland Totonac
Hiligaynon
Hindi
Hindko
Hinukh
Hmong
Ho
Huambisa
Huichol
Huitotot
Hungarian
Ibibio-Efik
Icelandic
Igbo
Ijaw (Izon)
Ilokano
Inari Sami
Indonesian
Ingrian
Ingush
Inuinnaqtun
Inuktitut
Inupiaq
Irish
Irish
Italian
Iu Mien
Jamaican Creole
Japanese
Jaqaru
Javanese
Judeo-Berber
Jula
K'iche'
Kabardian
Kaiwá
Kala Lagaw Ya
Kalaallisut
Kalenjin
Kalmyk
Kamba
Kannada
Kanuri
Kapampangan
Karachay-Balkar
Karelian
Karen
Kashmiri
Kashubian
Kayardild
Kazakh
Khakas
Khandeshi
Khanty
Khinalug
Khmer
Kildin Sami
Kimbundu
Kinaray-a
Kinyarwanda
Kirundi
Kodava Takk
Koli
Komi
Komi-Permyak
Kongo
Konkani
Korean
Koryak
Kumauni
Kumyk
Kurdish
Kurux
Kven
Kwanyama
Kyrgyz
Ladin
Ladino
Lak
Lakota
Lampung
Lao
Latvian
Laz
Leonese
Lezgian
Ligurian
Limbu
Limburgish
Lingala
Lithuanian
Livonian
Llanito
Lombard
Lozi
Ludic
Luganda
Lugbara
Lule Sami
Luo (Dholuo)
Luri
Lusoga
Luxembourgish
Luyia
Macedonian
Madurese
Magindanaw
Mahl
Maithili
Makasar
Makhuwa
Makonde
Malagasy
Malay
Malayalam
Maltese
Malvi
Manchu
Mandarin
Mandinka
Maninka
Mansi
Manx Gaelic
Maori
Mapudungun
Mara
Maranao
Marathi
Mari
Mazahua
Mazanderani
Mbyá Guaraní
Meänkieli
Megleno-Romanian
Meithei
Memoni
Mende
Meru
Mezquital Otomi
Míkmawísimk
Min
Minangkabau
Minica Huitoto
Mirandese
Miskito
Mlabri
Moksha
Mongolian
More
Mundari
Murui Huitoto
Naga
Nahuatl
Nàmá
Navajo
Ndebele
Ndonga
Neapolitan
Nenets
Nepali
Ngäbere
Nganasan
Nivaclé
Nogai
North Frisian
Northern Sami
Northern Sotho (sePedi)
Norwegian
Nyakyusa
Nyamwezi
Nyankore
Occitan
Ojibwe
Ometo
Oriya
Orizaba Nahuatl
Oromo
Ossetic
Other
Ottoman
P'urhépecha
Pahari-Potwari
Paiwan
Pajonal Ashéninka
Pangasinan
Papiamento
Pardhan
Parsi/Farsi/Persian/Dari
Pashto
Perené Ashéninka
Persian
Pichis Ashéninka
Piemonteis
Pite Sami
Pitkern (Or Pitcairnese)
Polish
Pontic Greek
Portuguese
Punjabi
Quechua
Qusqu-Qullaw
Rajbangsi
Rapa Nui (Easter Islander)
Rejang
Romani
Romanian
Romansh
Russian
Rutul
Ryukyu
Saisiyat
Sakha
Samoan
Sanskrit
Santali
Santiago del Estero Quichua
Sara
Sardinian
Sasak
Saterland Frisian (East Frisian)
Scots
Scottish Gaelic
Selkup
Sena
Senoufo
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Serer
Sesotho
Shan
She
Shona
Shor
Sidamo
Sindhi
Sinhalese
Sioux
SiSwati
Skolt Sami
Slovak
Slovenian
Somali
Songe
Soninke
South Bolivian Quechua
South Estonian
South Ucayali Ashéninka
Southern Aymara
Southern Quechua
Southern Sami
Spanish
Sukuma
Sunda
Susu
Swahili
Swedish
Taba
Tabasaran
Tagalog (including Filipino)
Tahitian
Tajik
Tamang
Tamil
Tatar
Tausug
Tày
Telugu
Temne
Ter Sami
Teso
Thai
Tharu
Tibetan
Ticuna
Tigrigna
Tiv
Tobian
Tonga
Tongan
Tsez
Tshiluba
Tsonga
Tswana
Tuamotuan
Tuareg
Tulu
Tumbuka
Turkish
Turkmen
Tuvaluan
Tuvan
Ucayali-Yurúa Ashéninka
Udmurt
Ukrainian
Umbundu
Ume Sami
Urdu
Urhobo
Uyghur
Uzbek
Venda
Veps
Vietnamese
Vlaams (Flemish)
Vlax Romani
Võro
Votic
Walloon
Walmajarri
Wanka Quechua
Warao
Waray-Waray
Warlpiri
Washo
Wayuu
Welsh
West Frisian
Western Argentine Guaraní
Western Desert Language
Western Huasteca Nahuatl
Wichí Lhamtés Güisnay
Wichí Lhamtés Vejoz
Wolof
Wu
Xhosa
Xiang
Yaghnobi
Yague
Yao
Yi
Yiddish
Yoruba
Yucatán Maya
Zapotec
Zarma
Zazaki
Zhuang
Zulu
Zuñi
Level of Spoken English
--- English Level ---
None
Basic
Intermediate
Fluent
Highest Education
--- Education Level ---
No Formal Education
Primary school (8 years or less)
Some Secondary school (Grades 9 to 12) no Diploma
Secondary school diploma/Certificate/GED
Vocational Training Certificate
Some Post Secondary (College/University, w/o credential)
College diploma
University degree (Bachelor's)
Professional Accreditation (P. Eng, Teacher, etc)
University degree (Master's)
University degree (Doctorate/Ph. D.)
NOC. Occupational / Professional Background
Contextual Help
Dynamic for every field
Referral Sources
Please tell us how you found out about COSTI by selecting from the options below:
COSTI Website
Transit Ads (bus or bus shelter)
COSTI Sign
Community Partner
Search Engine, such as Google
Community Event
Other Website
Friend/ Word of Mouth
Job Fair
Instagram
Newspaper
Twitter
Brochure/ flyer
Facebook
Hot Sign
Other
Billboard
Consent to Receive Email News and Communiques
Yes, I am interested in receiving emails from COSTI regarding the services I am receiving. I am also interested in receiving emails regarding:
Announcements about programs and services
Employment opportunities, jobs fairs
Employer hosted events
Fundraising Events
Workshops
Membership Campaigns, including Friends of COSTI
Newsletters
Languages Bureau
Summer English Language and Cultural Experience Program
Skills Training Courses including MS Office, Outlook, AccPac, Simply Accounting or any new course
No, I am not interested in receiving any emails from COSTI.
Consent for IRCC
I have read the Consent Statement for Immigration, Refugees & Citizenship Canada (IRCC). I hereby give consent for IRCC to contact me in the future for the sole purpose of asking questions relating to IRCC services provided to me by COSTI.
Consent for Disclosure of Personal Information
COSTI recognizes that information provided in the Client Registration Form is confidential and will not be released without my prior consent. I hereby give consent to COSTI to share the information I have provided herein to staff within COSTI for the sole purpose of providing services to me. I understand that COSTI will use aggregate statistical data from the Client Registration System for planning and presentation purposes.
I have read the statement and agree
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