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	Nemesio, Jr
Middle Name	Rivera
Last Name	Layos
Place of Birth	Binalonan Pangasinan
Country of Citizenship	Philippines
EDUCATION	Vocational/Trade/Apprenticeship
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	Gerlie Jou
Middle Name	Fabro
Last Name	Basanes
Birth Date (m/d/y)	16021982
Place of Birth	Binalonan Pangasinan
Country of Citizenship	Philippines
N.B. Additional information on your spouse (if applicable), i.e. education, work experience could be provided on extra Space below	Graduated Caregiver NC II Online Seller for 5 yrs Caregiver for 6 yrs
CHILDREN'S DETAIL (IF ANY)	CHILDREN'S DETAIL (IF ANY)
1. Name	Joyelie Basanes
Date of Birth (mm/dd/yyyy)	16062004
Place of Birth	Binalonan Pangasinan
2. Name	Kendrick Basanes
Date of Birth (mm/dd/yyyy)	30112012
Place of Birth	Manila Quezon City
3. Name	Josh Layos
Date of Birth (mm/dd/yyyy)	10102013
Place of Birth	Manila Quezon City
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	Toronto
Province	Toronto
UPLOAD RESUME	dalem.doc
CONTACT DETAILS	CONTACT DETAILS
Address	Zone 3 Santa Maria Norte Binalonan Pangasinan 2436 Philippines
Contact Number	(916) 790-4348
Email Address	Email hidden; Javascript is required.
Fax Number	None