Form view – Canadian Provincial Nominee & Immigration Services

PLEASE SPECIFY CATEGORY FOR WHICH YOU ARE APPLYING	Family Class
PERSONAL INFORMATION	PERSONAL INFORMATION
Title	Mrs.
First Name	Charimae
Middle Name	Samson
Last Name	Roma
Place of Birth	Dumaguete City
Country of Citizenship	Philippines
EDUCATION	Bachelor's Degree
Current Occupation	Nurse
Occupation in Years	8
Occupation in Months	0
LANGUAGE PROFICIENCY	LANGUAGE PROFICIENCY PRINCIPAL APPLICANT
English	Excellent Very Good
French	Fair
Specify Other Language	Filipino
MARITAL STATUS	Married
LANGUAGE PROFICIENCY SPOUSE	LANGUAGE PROFICIENCY SPOUSE
English	Good
French	Fair
Specify Other Language	Filipino
SPOUSE DETAIL	SPOUSE DETAIL
Title	Mr.
First Name	Michael
Middle Name	Paraguya
Last Name	Roma
Birth Date (m/d/y)	29/09/1983
Place of Birth	Cebu City
Country of Citizenship	Philippines
CHILDREN'S DETAIL (IF ANY)	CHILDREN'S DETAIL (IF ANY)
1. Name	Juanne Simoune Roma
Date of Birth (mm/dd/yyyy)	24/06/2005
Place of Birth	Dumaguete City
2. Name	Micha Zion Roma
Date of Birth (mm/dd/yyyy)	29/06/2010
Place of Birth	Cebu City
DO YOU HAVE ANY RELATIVES IN CANADA?	Yes
WHERE DO YOU INTEND TO LIVE IN CANADA?	WHERE DO YOU INTEND TO LIVE IN CANADA?
City/Town	Toronto
Province	Ontario
CONTACT DETAILS	CONTACT DETAILS
Address	18 Soyer Court Woking Surrey United Kingdom
Contact Number	(793) 065-3881
Email Address	Email hidden; Javascript is required.