Form view – Canadian Provincial Nominee & Immigration Services

PLEASE SPECIFY CATEGORY FOR WHICH YOU ARE APPLYING	Family Class
PERSONAL INFORMATION	PERSONAL INFORMATION
Title	Mr.
First Name	M Nofri
Last Name	Andy
Birth Date (m/d/y)	11/16/1984
Place of Birth	Pkl brandan indinesia
Country of Citizenship	Sumatera utara
EDUCATION	Secondary/High School
Current Occupation	Film crew
Occupation in Years	10 years
Occupation in Months	10 mount
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	Anita
Last Name	Susanti
Birth Date (m/d/y)	6/25/1985
Place of Birth	Kalianda
Country of Citizenship	Lampung selatan
CHILDREN'S DETAIL (IF ANY)	CHILDREN'S DETAIL (IF ANY)
1. Name	Muhammad daffa azizan arsyil
Date of Birth (mm/dd/yyyy)	8/7/2012
Place of Birth	Jakarta
2. Name	Azra nurshalfa zaura
Date of Birth (mm/dd/yyyy)	10/05/2013
Place of Birth	Jakarta
3. Name	Azqiara nurandita azura
Date of Birth (mm/dd/yyyy)	12/13/2019
Place of Birth	Kab. Bekasi
DO YOU HAVE ANY RELATIVES IN CANADA?	No
WHERE DO YOU INTEND TO LIVE IN CANADA?	WHERE DO YOU INTEND TO LIVE IN CANADA?
Province	South canada
CONTACT DETAILS	CONTACT DETAILS
Address	Cibarusah jaya blok E4 no 11 kab bekasi
Contact Number	+6283830884274
Email Address	Email hidden; Javascript is required.