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	Rian
Last Name	Anugerah
Place of Birth	Maluku
Country of Citizenship	Indonesia
EDUCATION	Secondary/High School
LANGUAGE PROFICIENCY	LANGUAGE PROFICIENCY PRINCIPAL APPLICANT
English	Good
French	Fair
MARITAL STATUS	Married
LANGUAGE PROFICIENCY SPOUSE	LANGUAGE PROFICIENCY SPOUSE
English	Good
French	Fair
SPOUSE DETAIL	SPOUSE DETAIL
Title	Mrs.
First Name	Juli
Last Name	Hanzarwati
Birth Date (m/d/y)	30 juli 1981
Place of Birth	Karang anyar
Country of Citizenship	Indonesia
CHILDREN'S DETAIL (IF ANY)	CHILDREN'S DETAIL (IF ANY)
1. Name	Muhammad fikri hidayat
Date of Birth (mm/dd/yyyy)	9 juli 2003
Place of Birth	Yogyakarta
2. Name	Maulana ziljian anugerah
Date of Birth (mm/dd/yyyy)	11 10 2009
Place of Birth	Medan
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	Winnipeg
Province	Manitoba
CONTACT DETAILS	CONTACT DETAILS
Address	Dusun VIIA, Karang Anyar, Beringin, Deli Serdang, North Sumatera, Indonesia
Contact Number	(061) 795-3941
Email Address	Email hidden; Javascript is required.