Form view – Canadian Provincial Nominee & Immigration Services

PLEASE SPECIFY CATEGORY FOR WHICH YOU ARE APPLYING	Skilled Worker
PERSONAL INFORMATION	PERSONAL INFORMATION
Title	Mr.
First Name	SURANTO
Middle Name	SURANTO -
Last Name	-
Place of Birth	INDRAMAYU
Country of Citizenship	INDONESIA
EDUCATION	College
Other Eduction	ACADEMY OF HOTEL &TOURISM
Current Occupation	CHEF / COOK
Occupation in Years	2007
Occupation in Months	06
LANGUAGE PROFICIENCY	LANGUAGE PROFICIENCY PRINCIPAL APPLICANT
English	Very Good
French	Fair
Specify Other Language	Germany
MARITAL STATUS	Married
LANGUAGE PROFICIENCY SPOUSE	LANGUAGE PROFICIENCY SPOUSE
English	Fair
French	Fair
SPOUSE DETAIL	SPOUSE DETAIL
Title	Mrs.
First Name	LIA
Middle Name	THALITA
Last Name	-
Birth Date (m/d/y)	06/05/1989
Place of Birth	JAKARTA
Country of Citizenship	INDONESIA
CHILDREN'S DETAIL (IF ANY)	CHILDREN'S DETAIL (IF ANY)
1. Name	ALVAREEN REZQIANO
Date of Birth (mm/dd/yyyy)	08/09/2015
Place of Birth	BEKASI
2. Name	ALVIANDI BACHTIAR
Date of Birth (mm/dd/yyyy)	18/09/2020
Place of Birth	BEKASI
3. Name	-
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	TOWN
Province	Alberta
CONTACT DETAILS	CONTACT DETAILS
Address	VILLA INDAH PERMAI C19 NO 31 RT 04 RW 037 TELUKPUCUNG BEKASI UTARA 17121
Contact Number	(628) 788-3980
Email Address	Email hidden; Javascript is required.