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)

__________________________________________________


Education and Training

17. Highest level of education achieved
  • Some Highschool
  • Highschool
  • Some College or University
  • College or University
18. Field of Study

__________________________________________________

19. Name of Last Educational Institution attended

__________________________________________________

20. Address or Location

__________________________________________________

21. Start date

__________________________________________________

22. End date

__________________________________________________



References (up to three)

23. Business and/or home address

__________________________________________________
Occupations

__________________________________________________

Daytime and evening phone numbers

__________________________________________________ Relationship to you

__________________________________________________

24. Business and/or home address

__________________________________________________
Occupations

__________________________________________________

Daytime and evening phone numbers

__________________________________________________ Relationship to you

__________________________________________________

25. Business and/or home address

__________________________________________________
Occupations

__________________________________________________

Daytime and evening phone numbers

__________________________________________________
Relationship to you

__________________________________________________



Work History; please include all employers in the last 3 years, including current employer

26. Name of employer

__________________________________________________
Mailing and street addresses

__________________________________________________

Phone Number

__________________________________________________
Last or beginning and ending salaries

__________________________________________________

Start dates

__________________________________________________
End date (write present if current employer.)

__________________________________________________

Your titles

__________________________________________________
Type of work you did

__________________________________________________

Business Contact information

__________________________________________________

Boss's name and titles

__________________________________________________

27. Name of employer

__________________________________________________

Phone Number

__________________________________________________

Start dates

__________________________________________________
End date (write present if current employer.)

__________________________________________________

Your titles

__________________________________________________
Type of work you did

__________________________________________________

Business Contact information

__________________________________________________

Boss's names and title

__________________________________________________

28. Name of employer

__________________________________________________
Mailing and street addresses

__________________________________________________

Phone Number

__________________________________________________
Last or beginning and ending salaries

__________________________________________________

Start dates

__________________________________________________
End date (write present if current employer.)

__________________________________________________

Your titles

__________________________________________________
Type of work you did

__________________________________________________

Business Contact information

__________________________________________________

Boss's names and titles

__________________________________________________