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Canadian expatriates visitors to Canada expatriates to Canada Applicants name (please print) MM/DD/YYY Date Detailed medical questionnaire Underwritten by Cooperators Life Insurance Company. How to
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To fill out the applicant's name, please print it as follows:

01
Write the applicant's first name in capital letters: JOHN.
02
Write the applicant's middle name, if applicable, in capital letters: ALEXANDER.
03
Write the applicant's last name in capital letters: SMITH.
The applicants' name please print is required by various individuals or organizations, including:
01
Employers: When applying for a job, employers often require applicants to print their name to ensure legibility and accuracy in the hiring process.
02
Educational institutions: When applying for admission to schools or universities, applicants may be asked to print their name to avoid confusion or errors.
03
Government agencies: When submitting forms or applications to government agencies, such as for passports or driver's licenses, applicants are often required to print their name for clarity and consistency.

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The applicant's name should be printed exactly as it appears on official documents.
The applicant themselves or their authorized representative may file their name.
The applicant should type or write their name clearly and legibly in the designated space.
The purpose of listing the applicant's name is for identification and record-keeping purposes.
The applicant's full legal name must be reported accurately.
The deadline to file the applicant's name in 2024 is December 31st.
The penalty for late filing of the applicant's name may result in processing delays or administrative fines.
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