Form view – Canadian Provincial Nominee & Immigration Services

PLEASE SPECIFY CATEGORY FOR WHICH YOU ARE APPLYING	Self Employed
PERSONAL INFORMATION	PERSONAL INFORMATION
Title	Mr.
First Name	Ariffani
Middle Name	Ariffani Ariffani
Last Name	Ariffani
Place of Birth	Indonesia
Country of Citizenship	Indonesia
EDUCATION	Secondary/High School
LANGUAGE PROFICIENCY	LANGUAGE PROFICIENCY PRINCIPAL APPLICANT
English	Fair
French	Fair
MARITAL STATUS	Married
LANGUAGE PROFICIENCY SPOUSE	LANGUAGE PROFICIENCY SPOUSE
English	Fair
French	Fair
SPOUSE DETAIL	SPOUSE DETAIL
Title	Ms.
First Name	Rahmawati
Middle Name	Ariffani Ariffani
Last Name	Ariffani
Birth Date (m/d/y)	13/05/1987
Place of Birth	Indonesia
Country of Citizenship	Indonesia
CHILDREN'S DETAIL (IF ANY)	CHILDREN'S DETAIL (IF ANY)
1. Name	Syasya Almira Noor Maulida
Date of Birth (mm/dd/yyyy)	03/01/2015
Place of Birth	South Kalimantan,Indonesia
2. Name	Muhammad Rafa Zuhdiannoor
Date of Birth (mm/dd/yyyy)	08/06/2020
Place of Birth	South Kalimantan, Indonesia
3. Name	Muhammad Umar Alfaruq
Date of Birth (mm/dd/yyyy)	24/09/2021
Place of Birth	South Kalimantan, 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	All of Canada
Province	All of Canada
UPLOAD RESUME	inbound4244247679116789908.pdf
CONTACT DETAILS	CONTACT DETAILS
Address	South Kalimantan, Indonesia (+62)85151447045
Contact Number	(628) 515-1447
Email Address	Email hidden; Javascript is required.