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Employer Address Please explain reason for periods of unemployment longer than three 3 months between Job 1 and present. Employment dates Phone Number Reason for Leaving Please give detail Title Supervisor s Name May we contact your present employer Phone Number Not currently employed Return Application to our office located in the Student Union Building SU 2005 or mail to AVI Foodsystems email or mail to a MS. Slippery Rock University Toledo OH 43606 Weisenfluh Dining Hall Slippery Rock PA 16057 Signature Date. Last Name First Middle Former Name If any Social Security No. Present Address Telephone No. No. Are you 18 years of age or older Length of time at present address Street Yes City No State Zip Country If no list your date of birth Position applied for Hourly Rate/Salary Expected Be Specific Are you willing to work Mornings Days Nights Saturdays Were you previously employed by AVI FOODSYSTEMS Inc. In the event of an emergency who should be notified NAME PHONE HOME WORK How did you happen to apply for this job Sundays No If yes dates/location RELATIONSHIP PLACE OF BUSINESS List any friends and/or relatives working for AVI FOODSYSTEMS Inc. Name Relationship Have you been convicted of a crime within the past seven years excluding minor traffic offences No If yes state the crime and describe what happened. A criminal conviction will not disqualify you from consideration Employment History 1. An Equal Opportunity Employer Application for Employment AVI FOODSYSTEMS Inc* subscribes without reservation to all federal state and local statues that prohibit discrimination in Employment because of race creed color age sex sexual preference religion national origin handicap or veteran s status. Answers to information requested in this application will be evaluated solely for the purpose of determining your qualifications to perform the job for which you are applying. Instructions Please print neatly. This application must be completed and signed personally by the applicant. Each question must be answered in full* If no or none is used as an answer please state. PLEASE USE INK. Employer Address Please explain reason for periods of unemployment longer than three 3 months between Job 1 and present. Employment dates Phone Number Reason for Leaving Please give detail Title Supervisor s Name May we contact your present employer Phone Number Not currently employed Return Application to our office located in the Student Union Building SU 2005 or mail to AVI Foodsystems email or mail to a MS* Slippery Rock University Toledo OH 43606 Weisenfluh Dining Hall Slippery Rock PA 16057 Signature Date. An Equal Opportunity Employer Application for Employment AVI FOODSYSTEMS Inc* subscribes without reservation to all federal state and local statues that prohibit discrimination in Employment because of race creed color age sex sexual preference religion national origin handicap or veteran s status. Answers to information requested in this application will be evaluated solely for the purpose of determining your qualifications to perform the job for which you are applying. .

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