| Personal | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Last Name | Bays | ||||||||||||||||
| First Name | Jacob | ||||||||||||||||
| Middle Name | Matthew | ||||||||||||||||
| Home Phone | (217) 508-3161 | ||||||||||||||||
| Cell Phone | (217) 508-3161 | ||||||||||||||||
| Email hidden; Javascript is required. | |||||||||||||||||
| Permanent Address | 1003 6th St Charleston, Illinois 61920 United States Map It | ||||||||||||||||
| Drivers License State | Illinois | ||||||||||||||||
| Social Security Number (voluntary) | 342-94-7307 | ||||||||||||||||
| Have you ever applied for a job at Drake Homes in the past? | No | ||||||||||||||||
| Have you ever been employed by Drake Homes in the past? | No | ||||||||||||||||
| How were you referred to Drake Homes? | Self | ||||||||||||||||
| Employment Interests | |||||||||||||||||
| Date Available | 11/12/2020 | ||||||||||||||||
| Position(s) Applying For | Any | ||||||||||||||||
| Type of Employment You Are Seeking: |
| ||||||||||||||||
| What is your desired hourly wage? | $8.25 | ||||||||||||||||
| Can you travel if the job requires it? | Yes | ||||||||||||||||
| Do you have a CDL? | No | ||||||||||||||||
| Do you have at least 1 year of relevant work experience? | Yes | ||||||||||||||||
| Education/U.S. Military Service | |||||||||||||||||
| Where did you attend high school & college? (Click the + button to add a new row) |
| ||||||||||||||||
| Have you ever served in the U.S. Armed Services? | No | ||||||||||||||||
| Employment History | |||||||||||||||||
| Company Name (Most Recent) | Jasper County Ambulance Service | ||||||||||||||||
| Address | Newton, Illinois 62448 Map It | ||||||||||||||||
| Phone | (618) 783-8653 | ||||||||||||||||
| Dates Employed |
| ||||||||||||||||
| Job Title | EMT | ||||||||||||||||
| Supervisors Name & Title | Daniel Alzate EMT | ||||||||||||||||
| Type of Business | Ambulance | ||||||||||||||||
| Description of duties | Performed patient care duties as well as maintenance of equipment and working around heavy machinery and apparatus in various environments. | ||||||||||||||||
| Reason for Leaving? | Career change | ||||||||||||||||
| May we contact this employer? | Yes | ||||||||||||||||
| Did you have another job before this one? | Yes | ||||||||||||||||
| Company Name (Second Most Recent) | Abbott Ambulance | ||||||||||||||||
| Address | Effingham, Illinois 62401 Map It | ||||||||||||||||
| Phone | (314) 768-1000 | ||||||||||||||||
| Dates Employed |
| ||||||||||||||||
| Job Title | EMT | ||||||||||||||||
| Supervisors Name & Title | Jeff Odenthal EMT | ||||||||||||||||
| Type of Business | Ambulance | ||||||||||||||||
| Description of duties | Performed patient care duties as well as maintenance of equipment and working around heavy machinery and apparatus in various environments. | ||||||||||||||||
| Reason for Leaving? | School conflict | ||||||||||||||||
| May we contact this employer? | Yes | ||||||||||||||||
| Would you like to list another previous job? | No | ||||||||||||||||
| References | |||||||||||||||||
| List 3-5 people we may contact who are qualified to evaluate your capabilities. Do not include relatives. (Click the + button to add a new row) |
| ||||||||||||||||
| Background | |||||||||||||||||
| I agree to a drug screening at the company's expense. | Yes | ||||||||||||||||
| Do you have the legal right to live and work in the U.S.? | Yes | ||||||||||||||||
| I agree/disagree to authorization for Motor Vehicle Report (MVR) at company's expense. | Agree | ||||||||||||||||
| I understand that this position requires a valid driver's license and proof will be required after hire. |
| ||||||||||||||||
| I agree to a Criminal Background Check at the company's expense. | Yes | ||||||||||||||||
| Acknowledgement | |||||||||||||||||
| Digital Signature: | Jacob Bays | ||||||||||||||||
| Date | 11/11/2020 | ||||||||||||||||
| Would you like to add a cover letter? | No |
