Devil's Coulee Dinosaur & Heritage Museum
P.O. Box 156
Warner AB T0K 2L0
Phone: 403-642-2118 Fax: 403-642-3660
dinoegg@telusplanet.net
www.devilscoulee.com
Please fill out using black or blue ink.
Personal Information
1. Last Name
2. First Name and Initials
_______________________________________________ ____________________________________________
3. Mailing Address
4. Phone number you can be reached at
_______________________________________________ ____________________________________________
5. Do you have a valid Social Insurance Number
__Yes
__No
6. Do you have at least a Class 5 driver's license?
__Yes
__No
Job Information
13. Position you are Applying for
14. Earliest date you could start work
__________________________________________________ __________________________________________________
15. Where did you hear about this position
16. Salary Desired (Competitive Salary Offered)
__________________________________________________ __________________________________________________
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Education and Training
17. Highest level of education achieved




Some High School
High School
Some College or University
College or University
19. Name of Last Educational Institution attended
18. Field of Study
__________________________________________________
20. Address or Location
__________________________________________________ __________________________________________________
21. Start date
22. End date
__________________________________________________ __________________________________________________
References (up to three)
23. Business and/or home address
Daytime and evening phone numbers
__________________________________________________ __________________________________________________
Occupations
Relationship to you
__________________________________________________ __________________________________________________
24. Business and/or home address
Daytime and evening phone numbers
__________________________________________________ __________________________________________________
Occupations
Relationship to you
__________________________________________________ __________________________________________________
25. Business and/or home address
Daytime and evening phone numbers
__________________________________________________ __________________________________________________
Occupations
Relationship to you
__________________________________________________ __________________________________________________
2
Work History; please include all employers in the last 3 years, including current employer
26. Name of employer
Phone Number
__________________________________________________ __________________________________________________
Mailing and street addresses
Last or beginning and ending salaries
__________________________________________________ __________________________________________________
Start dates
Your titles
__________________________________________________ __________________________________________________
End date (write present if current employer.)
Type of work you did
__________________________________________________ __________________________________________________
Business Contact information
Supervisor’s name
__________________________________________________ __________________________________________________
27. Name of employer
Phone Number
__________________________________________________ __________________________________________________
Start dates
Your titles
__________________________________________________ __________________________________________________
End date (write present if current employer.)
Type of work you did
__________________________________________________ __________________________________________________
Business Contact information
Supervisor’s name
__________________________________________________ __________________________________________________
28. Name of employer
Phone Number
__________________________________________________ __________________________________________________
Mailing and street addresses
Last or beginning and ending salaries
__________________________________________________ __________________________________________________
Start dates
Your titles
__________________________________________________ __________________________________________________
End date (write present if current employer.)
Type of work you did
__________________________________________________ __________________________________________________
Business Contact information
Supervisor’s name
__________________________________________________ __________________________________________________
3