Coopération Intégration Canada

Register for any service request at the CICAN legal clinic

1.Today's date

Fecha del día

2. Do you represent an organization on behalf of the client?

Oui/Yes
Non/No

If yes, what is the name of the organization?

statut et quoi

3. Are you a French speaking or Francophile newly arrived in Canada (Client Information)?

Oui/Yes
Nom/No

4. Low family income? Consider your family size and choose your after-tax family income bracket. (https://www150.statcan.gc.ca/t1/tbl1/fr/tv.action?pid=1110023201)

1 person in the family? After-tax family income less than or equal to $24,347
2 persons in family? Family income after taxes less than or equal to $29,632
3 persons as a family? After-tax family income less than or equal to $36,898
4 persons in family? Family income after taxes less than or equal to $29,632
5 persons as a family? After-tax family income less than or equal to $52,418
6 persons in your family? After-tax family income less than or equal to $58,133
7 persons or more as a family? After-tax family income less than or equal to $63,848
Other (different from the above revenues)

Services are free for low-income French-speaking families. Bring your recent notice of assessment and the proof of identity to your appointment.

5. Your first name and second name (coustumer information)

First

Last

6. Are you over 18 years old?

Oui/Yes
Non/No

If you are under 18 years old, you must be accompanied by a parent or legal guardian.

7. Your residential address:

Apartment number, Building number, Street name

8. Your postal code

Enter the postal code. Example k1K 0G8. Your residence must be in Ontario

9. Your email (Customer information)

10. Your telephone number (customer information)

Your telephone number

11. Your marital status

First name and Last name of your spouse

First

Last

Prénom & Nom

13. Your status in Canada

14. Your family size

15. Nombre d'adultes de plus de 15 ans

16. Number of children under 15 years old

17. Your source of income

18. Source of income of your spouse

19. What service do you need?

Solicitor's Declarations/Affidavits, RAFEO, Letters of Invitation, Powers of Attorney
Assermentation - certification

Other services are coming soon

Prestations sociales (assistance sociale, ODSP/POSPH, Securité de la vieillesse, assurance emploi)

Housing

Family

Immigration

Sexual Harassment in the Workplace (Summary Advice Only)

20. Name of your landlord

This field is only valid if you choose the housing service

21. Names of the roommate(s):

This field is only valid if you choose the housing service

22. Please describe the need in as much detail as possible. For example: Deadline, decision date, amount of debt, charges against you, people involved, etc.

23. If you are not French-speaking or if your income is above the low-income threshold, would you like to be referred?

Yes
No

24. Would you like to be contacted for other services offered by CICAN?

Yes
No

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By filling out this form, you agree to share your data with us. All data collected will be used only for the purpose of this booking and will not be shared with any third party unless you explicitly authorize it.