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	Puguh
Middle Name	Santoso
Last Name	Santoso
Place of Birth	Trenggalek
Country of Citizenship	Indonesia
EDUCATION	Bachelor's Degree
LANGUAGE PROFICIENCY	LANGUAGE PROFICIENCY PRINCIPAL APPLICANT
English	Good
French	Good Fair
MARITAL STATUS	Married
LANGUAGE PROFICIENCY SPOUSE	LANGUAGE PROFICIENCY SPOUSE
English	Good Fair
French	Fair
SPOUSE DETAIL	SPOUSE DETAIL
Title	Mrs.
First Name	Retno
Middle Name	Suminar
Last Name	Suminar
Birth Date (m/d/y)	17/04/1984
Place of Birth	Kediri
Country of Citizenship	Indonesia
CHILDREN'S DETAIL (IF ANY)	CHILDREN'S DETAIL (IF ANY)
1. Name	Akbar
Date of Birth (mm/dd/yyyy)	31/08/2009
Place of Birth	Kediri
2. Name	Akmal
Date of Birth (mm/dd/yyyy)	18/12/2012
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	All
Province	All
UPLOAD RESUME
CONTACT DETAILS	CONTACT DETAILS
Address	Street P. Diponegoro V no. 55 Tamanan Tulungagung Indonesia
Contact Number	(085) 735-5755
Email Address	Email hidden; Javascript is required.