Form view – Canadian Provincial Nominee & Immigration Services

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PLEASE SPECIFY CATEGORY FOR WHICH YOU ARE APPLYING	Family Class
PERSONAL INFORMATION	PERSONAL INFORMATION
Title	Mr.
First Name	Andree
Last Name	Dharmayan
Birth Date (m/d/y)	05/14/1979
Place of Birth	Jakarta, Indonesia
Country of Citizenship	100
EDUCATION	Bachelor's Degree
Current Occupation	Chef
Occupation in Years	4
Occupation in Months	48
LANGUAGE PROFICIENCY	LANGUAGE PROFICIENCY PRINCIPAL APPLICANT
English	Good
French	Fair
Specify Other Language	Indonesia
MARITAL STATUS	Married
LANGUAGE PROFICIENCY SPOUSE	LANGUAGE PROFICIENCY SPOUSE
English	Good
French	Fair
Specify Other Language	Indonesia
SPOUSE DETAIL	SPOUSE DETAIL
Title	Mrs.
First Name	Bekha
Middle Name	Widya
Last Name	Dharmayan
Birth Date (m/d/y)	11/19/1988
Place of Birth	Jakarta, Indonesia
Country of Citizenship	100
N.B. Additional information on your spouse (if applicable), i.e. education, work experience could be provided on extra Space below	Bachelor degree
CHILDREN'S DETAIL (IF ANY)	CHILDREN'S DETAIL (IF ANY)
1. Name	Abbe Alvaro Gavriel Dharmayan
Date of Birth (mm/dd/yyyy)	08/11/2014
Place of Birth	Jakarta, Indonesia
2. Name	Albee Aviel Gracio Dharmayan
Date of Birth (mm/dd/yyyy)	08/18/2016
Place of Birth	Jakarta, Indonesia
3. Name	Albher Abelano Given Dharmayan
Date of Birth (mm/dd/yyyy)	01/16/2018
Place of Birth	Jakarta, 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	Vancouver
Province	British Colombia
CONTACT DETAILS	CONTACT DETAILS
Address	Protos79a@yahoo.com
Contact Number	087808021979
Email Address	Email hidden; Javascript is required.