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	Richard
Middle Name	Valenzuela
Last Name	Chan
Place of Birth	Paranaque
Country of Citizenship	Philippines
EDUCATION	Bachelor's Degree
Occupation in Years	Restaurant service supervisor
LANGUAGE PROFICIENCY	LANGUAGE PROFICIENCY PRINCIPAL APPLICANT
English	Very Good
French	Fair
Specify Other Language	Dont speak french
MARITAL STATUS	Divorced/Separated
LANGUAGE PROFICIENCY SPOUSE	LANGUAGE PROFICIENCY SPOUSE
English	Very Good
French	Fair
Specify Other Language	Dont speak french
SPOUSE DETAIL	SPOUSE DETAIL
Title	Ms.
First Name	Supatmawati
Middle Name	No middle name
Last Name	No last name
Birth Date (m/d/y)	02/01/1989
Place of Birth	Karangasem
Country of Citizenship	Indonesia
N.B. Additional information on your spouse (if applicable), i.e. education, work experience could be provided on extra Space below	Bachelor of Science in Hotel Management
CHILDREN'S DETAIL (IF ANY)	CHILDREN'S DETAIL (IF ANY)
1. Name	Eirleen S. Chan
Date of Birth (mm/dd/yyyy)	19/06/2017
Place of Birth	Bali, Indonesia
2. Name	Eileen S. Chan
Date of Birth (mm/dd/yyyy)	19/06/2017
Place of Birth	Bali, Indonesia
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
Province	British Columbia
CONTACT DETAILS	CONTACT DETAILS
Address	Laspinas Metro Manila Philippines
Contact Number	(099) 935-8001
Email Address	Email hidden; Javascript is required.