| PLEASE SPECIFY CATEGORY FOR WHICH YOU ARE APPLYING | Family Class |
|---|---|
| PERSONAL INFORMATION | PERSONAL INFORMATION |
| Title | Mr. |
| First Name | Philip |
| Middle Name | Remandaban |
| Last Name | Agas |
| Place of Birth | Leyte |
| Country of Citizenship | Philippines |
| EDUCATION |
|
| Current Occupation | Casino cashier |
| Occupation in Years | 13 |
| 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 | Golda Marie |
| Middle Name | Adlawan |
| Last Name | Agas |
| Birth Date (m/d/y) | 06/05/1989 |
| Place of Birth | Ozamiz |
| Country of Citizenship | Philippines |
| N.B. Additional information on your spouse (if applicable), i.e. education, work experience could be provided on extra Space below | Bachelor in Science in Nursing |
| CHILDREN'S DETAIL (IF ANY) | CHILDREN'S DETAIL (IF ANY) |
| 1. Name | Gianna Xandrine A. Agas |
| Date of Birth (mm/dd/yyyy) | 04/22/2012 |
| Place of Birth | Ozamiz city |
| 2. Name | Gio Philippe Agas |
| Date of Birth (mm/dd/yyyy) | 04/08/2019 |
| Place of Birth | Cebu city |
| DO YOU HAVE ANY RELATIVES IN CANADA? | Yes |
| WHERE DO YOU INTEND TO LIVE IN CANADA? | WHERE DO YOU INTEND TO LIVE IN CANADA? |
| City/Town | Alberta |
| CONTACT DETAILS | CONTACT DETAILS |
| Address | Blk 1 Lot 5 Villa Alesandra Subdivision Canduman Mandaue City |
| Contact Number | (917) 707-6713 |
| Email Address | Email hidden; Javascript is required. |


