| PLEASE SPECIFY CATEGORY FOR WHICH YOU ARE APPLYING | PNP |
|---|---|
| PERSONAL INFORMATION | PERSONAL INFORMATION |
| Title | Mr. |
| First Name | Mohamad |
| Middle Name | Puji |
| Last Name | Haryanto |
| Place of Birth | Banjarnegara |
| 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 | Rismawati |
| Middle Name | Dwi |
| Last Name | Handayani |
| Birth Date (m/d/y) | 21/02/1984 |
| Place of Birth | Banyumas |
| Country of Citizenship | Indonesia |
| CHILDREN'S DETAIL (IF ANY) | CHILDREN'S DETAIL (IF ANY) |
| 1. Name | Muhammad Faisal Nur Hidayat |
| Date of Birth (mm/dd/yyyy) | 14/05/2004 |
| Place of Birth | Banyumas |
| DO YOU HAVE ANY RELATIVES IN CANADA? | No |
| WHERE DO YOU INTEND TO LIVE IN CANADA? | WHERE DO YOU INTEND TO LIVE IN CANADA? |
| UPLOAD RESUME | inbound6700374996360797788.pdf |
| CONTACT DETAILS | CONTACT DETAILS |
| Address | Griya Satria Bukit Permata Blok P No.2 Sidabowa RT.03 RW.09 Kec. Patikraja, Kab. Banyumas |
| Contact Number | (815) 796-6001 |
| 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
