Form view – Canadian Provincial Nominee & Immigration Services

PLEASE SPECIFY CATEGORY FOR WHICH YOU ARE APPLYING	PNP
PERSONAL INFORMATION	PERSONAL INFORMATION
Title	Mr.
First Name	Hendrik
Middle Name	Adi
Last Name	Wijaya
Place of Birth	Banyuwangi
Country of Citizenship	Indonesia
EDUCATION	Secondary/High School College
LANGUAGE PROFICIENCY	LANGUAGE PROFICIENCY PRINCIPAL APPLICANT
English	Excellent
French	Fair
MARITAL STATUS	Married
LANGUAGE PROFICIENCY SPOUSE	LANGUAGE PROFICIENCY SPOUSE
English	Very Good
French	Fair
SPOUSE DETAIL	SPOUSE DETAIL
Title	Mrs.
First Name	Mila
Middle Name	Rosiana
Last Name	Dewi
Birth Date (m/d/y)	25101987
Place of Birth	Denpasar
Country of Citizenship	Indonesia
CHILDREN'S DETAIL (IF ANY)	CHILDREN'S DETAIL (IF ANY)
1. Name	Harlan orlando wijaya
Date of Birth (mm/dd/yyyy)	08012015
Place of Birth	Denpasar
2. Name	Marielyn melvyn wijaya
Date of Birth (mm/dd/yyyy)	08072016
Place of Birth	Denpasar
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	Any city
Province	Any province
UPLOAD RESUME	inbound3339942282743638075.doc
CONTACT DETAILS	CONTACT DETAILS
Address	Jl gunung kalimutu no 29A
Contact Number	(819) 166-9977
Email Address	Email hidden; Javascript is required.