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	Sutikno
Middle Name	Sutikno
Last Name	.
Place of Birth	Banyuwangi
Country of Citizenship	Indonesia
EDUCATION	Others (specify)
Other Eduction	Diploma 3
Current Occupation	Waiter
Occupation in Years	15 years
LANGUAGE PROFICIENCY	LANGUAGE PROFICIENCY PRINCIPAL APPLICANT
English	Very Good
French	Fair
MARITAL STATUS	Married
LANGUAGE PROFICIENCY SPOUSE	LANGUAGE PROFICIENCY SPOUSE
English	Fair
French	Fair
SPOUSE DETAIL	SPOUSE DETAIL
Title	Mrs.
First Name	Suhartatik
Last Name	.
Birth Date (m/d/y)	11/03/1984
Place of Birth	Banyuwangi
Country of Citizenship	Indonesia
CHILDREN'S DETAIL (IF ANY)	CHILDREN'S DETAIL (IF ANY)
1. Name	Felicia putri lahaina
Date of Birth (mm/dd/yyyy)	16/01/2011
Place of Birth	Banyuwangi
2. Name	Naufal Raditya Alvaro
Date of Birth (mm/dd/yyyy)	21/08/2014
Place of Birth	Banyuwangi
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	Victoria
CONTACT DETAILS	CONTACT DETAILS
Address	Sumberjambe 03/03. Temurejo. Bangorejo.banyuwangi.j
Contact Number	(821) 250-7321
Email Address	Email hidden; Javascript is required.