| PLEASE SPECIFY CATEGORY FOR WHICH YOU ARE APPLYING | Skilled Worker |
|---|---|
| PERSONAL INFORMATION | PERSONAL INFORMATION |
| Title | Mr. |
| First Name | Riecaldo |
| Middle Name | Nelhans |
| Last Name | Daniel |
| Place of Birth | Jakarta |
| Country of Citizenship | Indonesia |
| EDUCATION |
|
| LANGUAGE PROFICIENCY | LANGUAGE PROFICIENCY PRINCIPAL APPLICANT |
| English |
|
| French |
|
| MARITAL STATUS | Married |
| LANGUAGE PROFICIENCY SPOUSE | LANGUAGE PROFICIENCY SPOUSE |
| English |
|
| French |
|
| SPOUSE DETAIL | SPOUSE DETAIL |
| Title | Mrs. |
| First Name | Silvana |
| Middle Name | Clementina |
| Last Name | Blei |
| Birth Date (m/d/y) | 18/06/1977 |
| Place of Birth | Jayapura |
| Country of Citizenship | Indonesia |
| N.B. Additional information on your spouse (if applicable), i.e. education, work experience could be provided on extra Space below | Bachelor Degree in Agriculture, majoring in Soil Science. |
| CHILDREN'S DETAIL (IF ANY) | CHILDREN'S DETAIL (IF ANY) |
| 1. Name | Pascalea Nadine Rievana Radjawane |
| Date of Birth (mm/dd/yyyy) | 18/04/2012 |
| Place of Birth | Jakarta |
| DO YOU HAVE ANY RELATIVES IN CANADA? | No |
| WHERE DO YOU INTEND TO LIVE IN CANADA? | WHERE DO YOU INTEND TO LIVE IN CANADA? |
| City/Town | Toronto |
| Province | Ontario |
| CONTACT DETAILS | CONTACT DETAILS |
| Address | Jl.Bunga No.2 Jakarta |
| Contact Number | (021) 851-5252 |
| Email Address | Email hidden; Javascript is required. |
Hi, How Can We Help You?
- Address: Madison Centre Tower | 4950 Yonge Street | Suite 1000 | Toronto | Ontario | M2N 6K1
- Email Address: inquiry@cpnis.com
