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America's

Service

Line, LLC

1814 Elizabeth Street
Green Bay, WI 54302
Phone: (800) 996-6440
Fax: (920) 430-8433
Recruiting
 
American Foods Group - Application for Employment

We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation or any other legally protected status.
Yankton, SD Mitchell, SD
Green Bay, WI Minneapolis, MN
Alexandria, MN South St. Paul, MN
Martinsville, VA Long Prairie, MN
Omaha, NE Bellevue, NE
Sharonville, OH Gibbon, NE
Position(s) applied for:
Date of Application:
Referral Source:  
Advertisement Professional Association
Employment Agency Job Fair
Job Service Internal Posting
Friend Walk-In
Relative Internet
College Recruit Mail
Company Contacted Other
Employee Referral    
Employee Refferal Name:
 
Last Name:
First Name:
Middle Name:
Address:
City:
State:
Zip:
Telephone Number(s):
Social Security Number: --
1. Are you 18 years of age or older?
YES NO
2. Have you filed an application here before?
YES NO
If yes, date(s):
3. Have you ever been employed by American Foods Group before?
YES NO
If yes, date(s):
4. Are you currently employed?
YES NO
5. May we contact your present employer?
YES NO
6. Are you prevented from lawfully becoming employed in this country because of Visa or immigration status? Proof of citizenship or immigration status will be required upon employment.
YES NO
7. On what date would you be available for work?
8.Are you available for work (pick one)?  
Full Time Shift Work
Part Time Temporary
What days?  
Sunday Thursday
Monday Friday
Tuesday Saturday
Wednesday    
9. Are you currently on a "lay-off" status and subject to recall?
YES NO
10. Do you have a dependable means of transportation to & from work?
YES NO
10. Have you been convicted of a felony within the last 7 years? Conviction will not necessarily disqualify an applicant from employment.
YES NO
If yes, explain:
 
Education
High School:
Name & Address of School::
Years Completed:
Course of Study:
  DIPLOMA   DEGREE
High School:
Name & Address of School::
Years Completed:
Course of Study:
  DIPLOMA   DEGREE
High School:
Name & Address of School::
Years Completed:
Course of Study:
  DIPLOMA   DEGREE
High School:
Name & Address of School::
Years Completed:
Course of Study:
  DIPLOMA   DEGREE
Additional Information

State any additional information you feel may be helpful to us in considering your application. Summarize special job-related skills & qualifications from employment or other experience.
 
Employment Experience

Start with your present or last job. Include any job-related military service assignments & volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, disabilities or other protected status.
1. Employer:
Address:
Telephone Number:
Job Title:
Supervisor:
Reason for leaving:
Work performed:
Dates Employed: From:           To:    
Hourly Rate/Salary: Starting:       Final: 
 
2. Employer:
Address:
Telephone Number:
Job Title:
Supervisor:
Reason for leaving:
Work performed:
Dates Employed: From:           To:    
Hourly Rate/Salary: Starting:       Final: 
 
3. Employer:
Address:
Telephone Number:
Job Title:
Supervisor:
Reason for leaving:
Work performed:
Dates Employed: From:           To:    
Hourly Rate/Salary: Starting:       Final: 
 
4. Employer:
Address:
Telephone Number:
Job Title:
Supervisor:
Reason for leaving:
Work performed:
Dates Employed: From:           To:    
Hourly Rate/Salary: Starting:       Final: 
 
References (Individuals not related to you and are not previous employers.)
1. Name:
Telephone Number:
Address:
2. Name:
Telephone Number:
Address:
3. Name:
Telephone Number:
Address:
 
Applicant’s Statement

I certify that answers given herein are true and complete to the best of my knowledge.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I release from all liability all persons, companies and corporations supplying such information. I also indemnify this Company against any liability which might result from making such investigation. Additionally, I authorize the Company to supply my employment record, in its sole discretion, in whole or in part, to any prospective employer, government agency, or other party, with an interest that the Company deems appropriate.

This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.

In the event of employment, I understand that false or misleading information given in my application or interviews(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.

I also understand that any offer of employment may be conditioned upon a health evaluation by a doctor selected by the Company, to determine whether I can perform the job duties. In addition, I understand a drug and/or alcohol test or background check may be required depending on Company policy.
Online Signature:
Date:
 
Applicant Data Record

As employers/government contractors, we comply with government and affirmative action responsibilities. To help us comply with government record keeping, reporting and other legal requirements, we would appreciate your cooperation in completing the Applicant Data Record.

This data is for periodic government reporting only and will be kept CONFIDENTIAL. This Data Record will be kept separate and will NOT be considered a part of your Application For Employment.
Position(s) applied for:
Referral Source:  
Advertisement Professional Association
Employment Agency Job Fair
Job Service Internal Posting
Friend Walk-In
Relative Internet
College Recruit Mail
Company Contacted Other
Employee Referral    
 
Applicant Last Name:
First Name:
Middle Name:
Telephone Number:
 
Affirmative Action Survey

Government agencies require periodic reports on the sex, ethnic and veteran background of applicants for employment. This data is for analysis and affirmative action only.

Check those that apply:
Male American Indian or Alaskan Native
Female
White Native Hawaiian or Pacific Islander
Asian
Hispanic or Latino Two or More Races
Black or African American    
1. Are you a person with a disability?
YES NO
2. Are you a veteran?
YES NO
Date of discharge or release from active duty:
3. Are you a Special Disabled Veteran?
YES NO
(A) a veteran who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Veterans Administration for disability (i) rated at 30 percent or more or (ii) rated at 10 or 20 percent in the case of a veteran who has been determined under section 1506 of this title to have a serious employment handicap; or (B) a person who was discharged or released from active duty because of a service-connected disability.
4. Are you a Vietnam Era Veteran?
YES NO
(1) served on active duty for a period of more than 180 days, and was discharged or released there from with other than a dishonorable discharge, if any part of such active duty occurred: (i) in the Republic of Vietnam between February 28, 1961 and May 7, 1975; or (ii) between August 5, 1964, and May 7, 1975, in all other cases; or (2) was discharged or released from active duty for a service-connected disability if any part of such active duty was performed: (i) in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or (ii) between August 5, 1964, and May 7, 1975, in all other cases.
5. Are you a Campaign/Expedition Veteran?
YES NO
A veteran who served on active duty during a war or in a campaign or expedition for which a campaign badge has been authorized (not Vietnam).
6. Are you an Other Protected Veteran?
YES NO
 
It is the policy at Rosen's Diversified, Inc. to provide equal employment and advancement opportunities to all qualified individuals. To achieve this goal, Rosen's Diversified, Inc. is dedicated to taking affirmative action to employ and advance in employment, minorities, women, qualified disabled persons, disabled veterans and veterans of the Vietnam Era. All personnel actions, including recruitment, hiring, training and promoting persons in all job titles, will be administered without regard to race, color religion, sex, national origin, age, disability or Vietnam Era veteran status or other protected basis and all employment decisions are based solely on valid job requirements.
Online Signature of Applicant:
Date:
Click SEND on both forms.
 
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