Form view – Canadian Provincial Nominee & Immigration Services

PLEASE SPECIFY CATEGORY FOR WHICH YOU ARE APPLYING	Other
PERSONAL INFORMATION	PERSONAL INFORMATION
Title	Mr.
First Name	Brando
Middle Name	-
Last Name	Sinaga
Place of Birth	Naga dolok
Country of Citizenship	Indonesia
EDUCATION	Secondary/High School
Current Occupation	Seaman
Occupation in Years	Seaman
Occupation in Months	Seaman
LANGUAGE PROFICIENCY	LANGUAGE PROFICIENCY PRINCIPAL APPLICANT
English	Good
French	Fair
Specify Other Language	Indonesian language
MARITAL STATUS	Married
LANGUAGE PROFICIENCY SPOUSE	LANGUAGE PROFICIENCY SPOUSE
English	Good
French	Fair
Specify Other Language	Indonesian language
SPOUSE DETAIL	SPOUSE DETAIL
Title	Ms.
First Name	Tetti
Middle Name	-
Last Name	Ambarita
Birth Date (m/d/y)	20-01-1982
Place of Birth	Kampung durian
Country of Citizenship	Indonesian
CHILDREN'S DETAIL (IF ANY)	CHILDREN'S DETAIL (IF ANY)
1. Name	Zivana Meira sinaga
Date of Birth (mm/dd/yyyy)	04-04-2010
Place of Birth	Batam
2. Name	Effraim Juniardi sinaga
Date of Birth (mm/dd/yyyy)	21-06-2013
Place of Birth	Batam
3. Name	Rumondang Anabel sinaga
Date of Birth (mm/dd/yyyy)	27-04-2018
Place of Birth	Batam
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 Colombia
CONTACT DETAILS	CONTACT DETAILS
Address	Bengkong palapa swadaya blok T no 10 Batam,Kepri,Indonesia
Contact Number	(081) 372-9620
Email Address	Email hidden; Javascript is required.