Manitoba Public Insurance | Application for Employment

This page will be unavailable on Sunday, February 14, 2010.

Please answer the following questions carefully. For more information about filling out this form,
go to How to apply. (*Required Fields)

*Position Applied for:
*Have you worked for Manitoba Public Insurance in the past?	YesNo

Personal Information
*First Name:
*Last Name:
*Address 1:
Address 2:
*City/Town:
*Province/State:
*Postal Code/Zip:
*Email:
Telephone Number(s)
Residence	( ) -
Business	( ) -
Cellular	( ) -

*Are you prepared to accept temporary employment?	YesNo
*What type of employment are you looking for?	SummerPart TimeFull Time

*Languages Spoken:

EnglishFrenchOther

Highest level of education completed (in descending order)
Type	Degree/Diploma/Certificate received	Specify if not listed	Year Completed

Experience
Previous Experience:	Years Experience:

Which of our locations would you like to be considered for? (Select all that apply)

Arborg	Beausejour	Brandon	Dauphin	Flin Flon	Portage la Prairie	Selkirk
Steinbach	Swan River	The Pas	Thompson	Winkler	Winnipeg

Have you ever been convicted of a criminal offence for which pardon has not been granted?

YesNo

How will you provide your resume and cover letter?

I will attach my resume and cover letter (recommended)

I will send my resume and cover letter via mail/fax (address and fax number will be provided on confirmation screen)

*I hereby declare that the foregoing information is true and complete to my knowledge. I understand that incorrect statements may disqualify me from employment, or cause my dismissal.