Position For Which You're Applying:

How did you learn of this opening?


Start Date Desired?


Rate Desired:

First Name:

Middle Name:

Last Name:

Address:

City:
State:AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Zip Code:
Home Phone:
Cell Phone:
Work Phone:
E-Mail:
Social Security Number:
Are you Over 21:
YesNo
For the purpose of compliance with the United States Immigration and Nationalization Act are you legally eligible for employment in the United States?
YesNo
Were you previously employed by Cavco Services Inc.? If so, please provide employment dates, position title and department.
YesNo
Have you ever been convicted of a felony or misdemeanor, other than minor traffic violations? If yes, please explain.
YesNo
Do you have a valid driver's license?
YesNo

Driver's License Details:
License Number: State Of Issue: Expiration Date:
Have you ever been fired or resigned from a position after being notified you would be fired? If yes, please explain.
YesNo
Please select the boxes that correspond to the evenings that you are available to work.MTWTFSaSu
Can you read and understand instructions written in English?
YesNo
Do you have dependable transportation of your own?
(Bus transportation does not qualify)
YesNo
Are you related to anyone employed by Cavco Services Inc? If yes, who?
YesNo
Do you have prior cleaning experience?
If yes, details:
YesNo

References: Please give the names of 3 persons NOT related to you, whom you have known at least one year. You must include their relationship to you and how long you have known them, as well as their phone number and occupation:

Present Employer:
Address:
Name of Supervisor:
Phone:
May we contact this employer? yesno
Day job start time:ampm
Day job finish time:ampm
Please name another adult living at your residence that we may contact in case of emergency:
Relationship to you:
Additional Emergency Contact (other than at your home):
Relationship to you:
Phone #:
High School Or Highest Grade Completed. Includes the location, dates you attended, degree or # of credits completed and date graduated:

College or University. Includes the location, dates you attended, degree or # of credits completed and date graduated:

Graduate School. Includes the location, dates you attended, degree or # of credits completed and date graduated:

Trade or Business School. Includes the location, dates you attended, degree or # of credits completed and date graduated:

If you expect to complete an educational program in the near future, please indicate what type of degree and when you expect to receive it:

List below present and past employment, beginning with the most recent. Include any related military service or volunteer work. If this would be your first job, please enter None in each field.

Latest Employer. Include their name, address, phone number, dates of employment and your supervisor:
Next Employer. Include their name, address, phone number, dates of employment and your supervisor:
Next Employer. Include their name, address, phone number, dates of employment and your supervisor:
Next Employer. Include their name, address, phone number, dates of employment and your supervisor:
Next Employer. Include their name, address, phone number, dates of employment and your supervisor:

I certify that the statements in this application are true and complete to the best of my knowledge, and I agree that any intentional misstatement or omission will constitute grounds for unfavorable consideration of my application or dismissal from employment with Cavco Services Inc.

I authorize Cavco Services Inc. to obtain information from past employers and other sources to support the data on this application, including a review of my educational, criminal and credit records, as appropriate.

You may contact my PRESENT employer: YesNo (please explain below)

I understand and agree that my employment is for no definite period and may, regardless of the date of payment of my wages or salary, be terminated at any time without any previous notice.

Date: