Form view – Canadian Provincial Nominee & Immigration Services

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PLEASE SPECIFY CATEGORY FOR WHICH YOU ARE APPLYING	PNP
PERSONAL INFORMATION	PERSONAL INFORMATION
Title	Ms.
First Name	Lilibeth
Middle Name	Lucas
Last Name	Antonio
Place of Birth	San Mateo Isabela Philippines
Country of Citizenship	Philippines
EDUCATION	Bachelor's Degree
Other Eduction	N/A
Current Occupation	Hemodialysis Nurse
Occupation in Years	20 years
Occupation in Months	240 months
LANGUAGE PROFICIENCY	LANGUAGE PROFICIENCY PRINCIPAL APPLICANT
English	Very Good
French	Fair
Specify Other Language	Filipino
MARITAL STATUS	Common Law
LANGUAGE PROFICIENCY SPOUSE	LANGUAGE PROFICIENCY SPOUSE
English	Very Good
French	Fair
Specify Other Language	Filipino
SPOUSE DETAIL	SPOUSE DETAIL
Title	Mr.
First Name	Albert
Middle Name	Lucero
Last Name	Lauang
Birth Date (m/d/y)	17/11/1070
Place of Birth	Nueva Vizcaya, Philippines
Country of Citizenship	Philippines
N.B. Additional information on your spouse (if applicable), i.e. education, work experience could be provided on extra Space below	Bachelor of Nursing Currently working as Hemodialysis Nurse in Acute Setting
CHILDREN'S DETAIL (IF ANY)	CHILDREN'S DETAIL (IF ANY)
1. Name	Chester Neal Agne
Date of Birth (mm/dd/yyyy)	23/04/1997
Place of Birth	Philippines
2. Name	Nicole Ann Agne
Date of Birth (mm/dd/yyyy)	02/08/1998
Place of Birth	Philippines
3. Name	Christian Kyle Agne
Date of Birth (mm/dd/yyyy)	23/03/2002
Place of Birth	Philippines
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	British Columbia
Province	Surrey
UPLOAD RESUME	inbound7434055261760900335.pdf
CONTACT DETAILS	CONTACT DETAILS
Address	Al Hada Armed Forces Hospital Taif KSA
Contact Number	(050) 090-4465
Email Address	Email hidden; Javascript is required.