Form view – Canadian Provincial Nominee & Immigration Services

PLEASE SPECIFY CATEGORY FOR WHICH YOU ARE APPLYING	Skilled Worker
PERSONAL INFORMATION	PERSONAL INFORMATION
Title	Mrs.
First Name	Gusri yanti
Middle Name	Yanti
Last Name	Gusri
Place of Birth	Padang
Country of Citizenship	Indonesia
EDUCATION	Secondary/High School
Other Eduction	-
Current Occupation	Cassier
Occupation in Years	2
Occupation in Months	18
LANGUAGE PROFICIENCY	LANGUAGE PROFICIENCY PRINCIPAL APPLICANT
English	Fair
French	Fair
Specify Other Language	-
MARITAL STATUS	Divorced/Separated
LANGUAGE PROFICIENCY SPOUSE	LANGUAGE PROFICIENCY SPOUSE
English	Fair
French	Fair
Specify Other Language	-
SPOUSE DETAIL	SPOUSE DETAIL
Title	Mrs.
First Name	Gusri yanti
Middle Name	Yanti
Last Name	Gusri
Birth Date (m/d/y)	15051985
Place of Birth	Padang
Country of Citizenship	Indonesia
CHILDREN'S DETAIL (IF ANY)	CHILDREN'S DETAIL (IF ANY)
1. Name	Kevin orlando valentino
Date of Birth (mm/dd/yyyy)	25042013
Place of Birth	Pariaman
2. Name	Vicky zikramul ikram
Date of Birth (mm/dd/yyyy)	10022016
Place of Birth	Pariaman
3. Name	Jacinda avantika rahma
Date of Birth (mm/dd/yyyy)	13032020
Place of Birth	Pariaman
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	Canada
Province	Canada
CONTACT DETAILS	CONTACT DETAILS
Address	Pariaman selatan
Contact Number	(380) 031-6131
Email Address	Email hidden; Javascript is required.
Fax Number	-