| PLEASE SPECIFY CATEGORY FOR WHICH YOU ARE APPLYING | Other |
|---|
| PERSONAL INFORMATION | PERSONAL INFORMATION |
|---|
| Title | Mrs. |
|---|
| First Name | Flor |
|---|
| Middle Name | Pérez |
|---|
| Last Name | Leyva |
|---|
| Place of Birth | La habana |
|---|
| Country of Citizenship | Cuba |
|---|
| EDUCATION | |
|---|
| Current Occupation | Supervicer of average and contaiments |
|---|
| Occupation in Years | 22 |
|---|
| LANGUAGE PROFICIENCY | LANGUAGE PROFICIENCY
PRINCIPAL APPLICANT |
|---|
| English | |
|---|
| French | |
|---|
| MARITAL STATUS | Divorced/Separated |
|---|
| LANGUAGE PROFICIENCY SPOUSE | LANGUAGE PROFICIENCY SPOUSE |
|---|
| English | |
|---|
| French | |
|---|
| SPOUSE DETAIL | SPOUSE DETAIL |
|---|
| Title | Mrs. |
|---|
| First Name | Flor |
|---|
| Middle Name | Pérez |
|---|
| Last Name | Leyva |
|---|
| Birth Date (m/d/y) | 18/11/1962 |
|---|
| Place of Birth | La Habana |
|---|
| Country of Citizenship | Cuba |
|---|
| CHILDREN'S DETAIL (IF ANY) | CHILDREN'S DETAIL (IF ANY) |
|---|
| DO YOU HAVE ANY RELATIVES IN CANADA? | Yes |
|---|
| WHERE DO YOU INTEND TO LIVE IN CANADA? | WHERE DO YOU INTEND TO LIVE IN CANADA? |
|---|
| CONTACT DETAILS | CONTACT DETAILS |
|---|
| Address | Luis Estevez#618 |
|---|
| Contact Number | (535) 323-5958 |
|---|
| Email Address | Email hidden; Javascript is required. |