Repair Service AL | R. C. Jacobs, Inc.

Call us today: (843) 527-2404

1824 Seitter Street, Georgetown SC 29440

Serving Your Community Since 1964

Repair Service AL | R. C. Jacobs, Inc.

Call us today:
(843) 527-2404

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Employment Inquiry

EMPLOYMENT INQUIRY FORM

Thank you for your interest in obtaining a position with R. C. Jacobs, Inc.. The following is a simple inquiry form to see if it is in your interest to take the time to come in and fill out our normal employment application and potentially interview for possible employment.

All information submitted will be held in strict confidence. No phone calls will be made to your current or past employers without first talking to you. R. C. Jacobs, Inc. is a drug-free workplace and will conduct a background check on all employee prospects before hiring.

Contact Information

Name

*First Name:

Middle Initial:

*Last Name:

Address

*Address:

*City:

*State/Province:

*Postal Code:

*Home Phone Number: Enter a valid phone number.

Personal Cell Phone Number: Enter a valid phone number.

*Email Address: Enter a valid email address.

*Confirm E-mail: Enter a valid email address.

Do you have a valid Driver's License?

Yes

No

*Type of Work Desired: This field is required.

*Days / Hours Available: This field is required.

Have you applied with us before:

If Yes, When:

Education & Certifications

High School

Number of years attended:

Did you graduate?

Yes

No

Name and Location of School:

Subjects Studied:

College

Number of years attended:

Did you graduate?

Yes

No

Name and Location of School:

Subjects Studied:

Trade or Business School

Number of years attended:

Did you graduate?

Yes

No

Name and Location of School:

Subjects Studied:

Current Certifications and Licenses:

Have you ever been convicted of a felony?

If yes, please provide details:

Employment History

Company Name:

Start Date:

End Date:

Starting pay rate:

Starting pay type

Hourly

Monthly

Annually

Ending pay rate:

Ending pay type

Hourly

Monthly

Annually

Duties:

Reason for Leaving:

Name of Supervisor:

Supervisor's Title:

Supervisor's Phone number or reason to not contact::

Company Name:

Start Date:

End Date:

Starting pay rate:

Starting pay type

Hourly

Monthly

Annually

Ending pay rate:

Ending pay type

Hourly

Monthly

Annually

Duties:

Reason for Leaving:

Name of Supervisor:

Supervisor's Title:

Supervisor's Phone number or reason to not contact::

Company Name:

Start Date:

End Date:

Starting pay rate:

Starting pay type

Hourly

Monthly

Annually

Ending pay rate:

Ending pay type

Hourly

Monthly

Annually

Duties:

Reason for Leaving:

Name of Supervisor:

Supervisor's Title:

Supervisor's Phone number or reason to not contact::

References

Reference 1 Name:

Reference 1 Phone Number: Enter a valid phone number.

Reference 2 Name:

Reference 2 Phone Number: Enter a valid phone number.

Reference 3 Name:

Reference 3 Phone Number: Enter a valid phone number.

Additional Skills

Other Skills:

Special Training:

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Our knowledgeable staff is here to help you: Call (843) 527-2404 today!

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