| PLEASE SPECIFY CATEGORY FOR WHICH YOU ARE APPLYING | Family Class |
|---|---|
| PERSONAL INFORMATION | PERSONAL INFORMATION |
| Title | Mr. |
| First Name | I Dewa |
| Middle Name | Putu |
| Last Name | Sidiarta |
| Place of Birth | Bali |
| Country of Citizenship | Indonesia |
| EDUCATION |
|
| Current Occupation | Hotel Industry |
| Occupation in Years | 12 |
| LANGUAGE PROFICIENCY | LANGUAGE PROFICIENCY PRINCIPAL APPLICANT |
| English |
|
| French |
|
| MARITAL STATUS | Married |
| LANGUAGE PROFICIENCY SPOUSE | LANGUAGE PROFICIENCY SPOUSE |
| English |
|
| French |
|
| Specify Other Language | Indonesia |
| SPOUSE DETAIL | SPOUSE DETAIL |
| Title | Mrs. |
| First Name | Ni Wayan |
| Middle Name | Ririn |
| Last Name | Widiastuti |
| Birth Date (m/d/y) | 26/03/1979 |
| Place of Birth | Bali |
| Country of Citizenship | Indonesia |
| CHILDREN'S DETAIL (IF ANY) | CHILDREN'S DETAIL (IF ANY) |
| 1. Name | None |
| 2. Name | None |
| 3. Name | None |
| 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 | Richmon Hill |
| Province | Ontario |
| CONTACT DETAILS | CONTACT DETAILS |
| Address | Jalan Cekomaria, Denpasar Utara, Bali - Indonesia |
| Contact Number | (081) 353-3995 |
| Email Address | Email hidden; Javascript is required. |
| Fax Number | 62.081353399560 |
Hi, How Can We Help You?
- Address: Madison Centre Tower | 4950 Yonge Street | Suite 1000 | Toronto | Ontario | M2N 6K1
- Email Address: inquiry@cpnis.com
