BSF935 – Application for Pacific Crest Trail (PCT) entry permit

Section A – Personal Information

I consent to have my permit issued electronically to the email address provided.1. Canadian immigration ID number (e.g., UCI or other immigration identifier)

• Last name
• First Name(s)
• Middle Name(s)
• Maiden name (if applicable)
• Country of Citizenship
• Email
• Date of Birth (YYYY-MM-DD)

Place of Birth

• City
• State/Province
• Country

Proof of Citizenship

Accepted documents include: passport, birth certificate, citizenship card/certificate or naturalization certificate. Photo ID is required and a copy of the documents must be submitted with your application.

• Document No.
• Country of Issuance
• Expiry Date

Other documents (required visas, etc.)

• Type
• Number
• Expiry Date

Section B – Address

• Phone No. 1
• Phone No. 2
• Street Address
• Apt. No.
• City
• Province/State
• Postal/Zip code
• Country

Mailing address if different from residential address:

• Street Address
• Apt. No.
• City
• Province/State
• Postal/Zip Code
• Country

Section C – Additional Information

Have you ever been convicted of one of the following offences for which you have not been pardoned:

• A crime or offence in any country, including a misdemeanour? Yes/No
• A contravention of the Canada Customs Act? Yes/No
• A contravention of the Immigration and Refugee Protection Act? Yes/No
• Have you, or any of your dependents to be included on the PCT permit, ever committed a criminal offence? Yes/No

If the answer is "Yes" to any of the questions, please provide details (type of conviction, date or conviction):

What is the purpose of your trip? (for non-residents of Canada only)

• Tourist
• Work
• Other

If the answer is "Yes" to any of the questions, please provide details (type of conviction, date or conviction):

I wish to have the following family members (spouse, children under the age of 18) included on my PCT permit (attach a separate sheet if necessary).

• Last Name (Include maiden name if applicable)
• First Name(s)
• Date of Birth Year – Month – Day
• Country of Citizenship
• Relationship to applicant
  • Spouse
  • Minor Child

Note: All firearms are prohibited entry into Canada via the Pacific Crest Trail.

Section D – To be completed by all non-Canadian citizens and all non-Canadian permanent residents

• Approximate date of entry into Canada
• Approximate date of departure from Canada (Canadian citizens and permanent residents remaining in Canada do not need to fill this out.)

Section E – Certification

Privacy Statement

The information you provide in your application, including supporting documentation, is collected by the Canada Border Services Agency (CBSA) under section 11.1 of the Customs Act and is protected pursuant to both the Customs Act and the Privacy Act. Information collected for the purpose of the Pacific Crest Trail Entry Permit Program will only be used by the CBSA for purposes related the administration of the program, which includes conducting the applicable eligibility verifications to authorize the permit. In accordance with section 107 of the Customs Act and subsection 8(2) of the Privacy Act, information collected may also be disclosed to other government departments or agencies (including the Royal Canadian Mounted Police and Immigration, Refugees and Citizenship Canada). If the required information is not provided, your application may not be processed and the permit may not be granted.

Individuals to whom the information relates have rights of access to, correction of and protection of, their personal information under the Privacy Act. The collection, use, disclosure and retention of your personal information is described in Personal Information Bank # CBSA PPU 013. Instructions for obtaining information are provided in the CBSA's Information about Programs and Information Holdings (formerly Info Source), which is available at public libraries, government public reading rooms and on the Internet.

Individuals to whom the information relates also have the right to file a complaint to the Privacy Commissioner of Canada should they have a concern about how the CBSA handles their information. Instructions to File a privacy complaint about a federal institution

Consent Statement

I certify that all information given on this application, and in support of this application, was provided voluntarily and is true and complete.

I understand that any information on this application, any supporting documents, and any background information may be shared among CBSA authorities and among law enforcement and other government agencies in accordance with applicable laws. I certify that I have read, understood, and that I agree to abide by all conditions required for the use of the program, including all instructions and notices accompanying this application.

(or signature of parent/legal guardian if applicant is under 18 years of age)

• Name (print)
• Signature
• Date

Section F – CBSA Use Only

• Date Permit Issued
• Initials

Au moins huit semaines avant votre voyage, envoyez la demande dûment remplie et les copies des documents requis par courriel à : pacificcresttrail@cbsa-asfc.gc.ca

ou par la poste à :
Agence des services frontaliers du Canada
Centre de traitement – Pacific Crest Trail
28 – 176^th Street
Surrey (Colombie-Britannique)
V3Z 9R9

Telephone: 1-866-496-3987

For program eligibility and other information, please visit: Permit to enter Canada from the Pacific Crest Trail

Date modified:

2024-04-19