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Application for Nomination ( ainp 003 ). Employer-Driven Stream The personal information provided on this form and attachments is collected under the authority of section 33(c), and managed in accordance with the Freedom of Information and Protection of Privacy Act. The information will be used for the purpose of administering the Alberta Immigrant Nominee Program. If you have any questions about the collection of this information, you can contact the Alberta Immigrant Nominee Program, Suite 940, ATB Place North Tower, 10025 Jasper Avenue, Edmonton, Alberta, Canada, T5J 1S6. Email: Fax: 780-427-6560. A. Candidate Details File Number (office use): Candidate's family name: Candidate's given name(s): Candidate's Gender: Male Female Candidate's residential address: City / Town: Prov. / Terr. / State: Postal / Zip code: Country: Canada Candidate's mailing address: (check here if same as above).

AINP 003 (2014/06) ID # Page 1 of 7 Employer-Driven Stream Application for Nomination (AINP 003) The personal information provided on this form and attachments is collected under the authority of section 33(c), and managed in accordance

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