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	Ronalthus
Last Name	Rebhy
Birth Date (m/d/y)	23/08/1982
Place of Birth	Indonesia
Country of Citizenship	Indonesia
EDUCATION	Secondary/High School
Current Occupation	Driver
Occupation in Years	10th
LANGUAGE PROFICIENCY	LANGUAGE PROFICIENCY PRINCIPAL APPLICANT
English	Fair
French	Fair
MARITAL STATUS	Married
LANGUAGE PROFICIENCY SPOUSE	LANGUAGE PROFICIENCY SPOUSE
English	Fair
French	Fair
SPOUSE DETAIL	SPOUSE DETAIL
Title	Mrs.
First Name	Maria
Middle Name	Yulianti
Last Name	Retnaningtyas
Birth Date (m/d/y)	25/07/1984
Place of Birth	Jakarta
Country of Citizenship	Indonesia
CHILDREN'S DETAIL (IF ANY)	CHILDREN'S DETAIL (IF ANY)
1. Name	Estelle kinan abigaille sara
Date of Birth (mm/dd/yyyy)	28/03/2012
Place of Birth	Jakarta
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	Ottawa
Province	ottawaj
CONTACT DETAILS	CONTACT DETAILS
Address	Jl.sungai bambu 1 no.i rt.07 rw.09 tanjung priuk Jakarta Utara Indonesia
Contact Number	087822006001
Email Address	Email hidden; Javascript is required.