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The New York State Food Service Worker form, designated as OC-APP #4 20-484, serves as a critical application for individuals seeking to take the Food Service Worker 1 examination. This form is specifically designed for candidates applying to various state agencies, excluding the Office of Mental Health. The application process requires candidates to provide personal information, including their name, Social Security number, and contact details, ensuring proper identification and communication. Applicants must also confirm their eligibility to work in the United States and disclose any potential disqualifying factors, such as prior employment discharges or criminal convictions. Notably, the form includes a section for requesting reasonable accommodations, which is essential for ensuring accessibility during the examination process. Furthermore, veterans may claim additional credits based on their military service, which can enhance their competitive standing in the hiring process. The application also emphasizes the importance of completeness and accuracy, as any omissions may delay the evaluation of qualifications. Finally, the form underscores New York State's commitment to equal opportunity employment and the protection of personal privacy, ensuring that all applicants are treated fairly and with respect throughout the hiring process.

Similar forms

  • Job Application Form: Similar to the NYS Food Service Worker form, a job application form collects personal information, work history, and qualifications. Both documents require applicants to affirm the truthfulness of their statements, which can impact employment eligibility.

  • State Employment Application: This document is used for various positions within state agencies. Like the Food Service Worker form, it includes sections on eligibility, background checks, and additional qualifications, such as military service or educational credits.

  • Background Check Authorization Form: This form requests permission for employers to conduct background checks. It parallels the Food Service Worker form's requirement for fingerprinting and criminal background checks before appointment.

  • Medical Examination Consent Form: Similar in purpose, this form is used to obtain consent for medical evaluations as part of the hiring process. Both documents emphasize the necessity of medical examinations for specific job roles.

  • Equal Employment Opportunity (EEO) Form: This form collects demographic information to ensure compliance with EEO laws. Like the Food Service Worker form, it addresses the importance of non-discrimination and equal opportunity in the hiring process.

Form Preview

APPLICATION FOR NEW YORK STATE EXAMINATIONS OPEN TO THE PUBLIC

 

 

 

 

 

 

 

 

 

 

OC-APP #4 20-484 (1/12L)

 

 

20-484 Food Service Worker 1

 

 

 

 

 

 

SIDE/PAGE 1

 

 

OPWDD, DOH, agencies

 

 

 

 

 

 

 

XD-72

 

 

 

 

Send your completed and signed application to

 

 

 

other than OMH

 

 

 

 

 

 

 

the facility Personnel Office where you would like to take the Food

 

 

 

 

 

 

 

Service Worker 1 examination.

 

 

Please read the announcement carefully

 

 

See list of locations available on the examination announcement at:

 

 

before completing this application.

 

 

http://www.cs.ny.gov/examannouncements/announcements/oc-

 

 

 

 

 

 

 

cr/decentralized/20-484.cfm

 

PRINT

Your Last Name

First Name

 

 

MI

 

 

Social Security Number

 

 

Street Number, Apt. or P.O. Box

 

 

 

 

Home Phone

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/

 

 

 

PLEASE

 

 

 

 

 

 

(

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-

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Area Code

 

 

 

 

 

 

City or Post Office

State

Zip Code

 

Business Phone

 

 

 

 

 

 

 

 

 

 

 

(

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-

 

 

 

 

 

 

 

 

 

 

Area Code

 

 

 

 

 

 

Please note:

1 - An examination for Food Service Worker 1 is also offered for the Office of Mental Health.

 

 

For information on the locations of these positions, refer to the announcement for

 

 

 

 

 

 

Exam No. 20-483 Food Service Worker 1 – Office of Mental Health.

 

 

 

 

 

 

 

2 - The same Food Service Worker 1 written test is used for both exam numbers 20-483 and

 

 

 

20-484. You may take the FOOD SERVICE WORKER 1 written test only ONCE every testform period.

 

 

 

(See details on the announcement.)

 

 

 

 

 

 

 

 

 

REASONABLE ACCOMMODATIONS IN TESTING

I require reasonable accommodations to take this test. (See the announcement for details.)

STUDENT LOANS

YES NO

YES NO

Have you any student loans made or guaranteed by the NYS Higher Education Services Corporation which are currently outstanding?

If so, are you currently in default of any such loan?

ADDITIONAL QUESTIONS

YES NO

YES NO

YES NO

YES NO

YES NO

Were you ever discharged from any employment except for lack of work or funds, disability or medical condition?

Did you ever resign from any employment rather than face discharge?

Did you ever receive a discharge from the Armed Forces of the United States which was other than “Honorable” or which was issued under other than honorable conditions?

Have you ever been convicted of any crime (felony or misdemeanor)?

Are you now under charges for any crime?

If you answered YES to any of these questions, provide details under REMARKS on Page 2. Your failure to answer any of these questions or to provide details will significantly delay any determination concerning your qualifications and may deprive you of potential employment opportunities.

ELIGIBILITY FOR EMPLOYMENT

You must be eligible to work in the United States at the time of appointment and throughout your employment with New York State. If appointed, you must produce documents that establish your identity and eligibility to work in the United States, as required by the Federal Immigration Reform and Control Act of 1986, and the Immigration and Nationality Act.

MEDICAL EXAMINATION, FINGER PRINTING AND BACKGROUND INVESTIGATION

A medical examination will be required for appointment.

Fingerprinting and criminal background check will be conducted if you are selected for appointment.

NOTE: Have you provided all requested information? An incomplete application may be disapproved.

I affirm under penalties of perjury that all statements made on this application (including any attached papers) are true. I understand that all statements made by me in connection with this application are subject to investigation and verification and that a material misstatement or fraud may disqualify me from appointment and/or lead to revocation of my appointment.

X

Signature of Applicant

Date

Please print any other last name by which you are or have been known.

Please continue application on Side/Page 2

YES NO
YES NO
YES NO
DO NOT COMPLETE THIS SECTION UNLESS YOU:

APPLICATION FOR NEW YORK STATE EXAMINATIONS OPEN TO THE PUBLIC

20-484 Food Service Worker 1

OC-APP #4 20-484 (1/12L)

OPWDD, DOH, agencies other than OMH

SIDE/PAGE 2

XD-72

 

EXTRA CREDITS FOR WAR TIME VETERANS

Answering these questions means that you are requesting the extra credits. Do not answer the questions if you are not a wartime active duty member of the armed forces or a war time veteran or if you do not want to request the extra credits.

If you are currently in the Armed Forces on full-time active duty (other than for training) or if you are a War Time Veteran or Disabled Veteran, you are eligible for extra credits added to your exam score if you pass. These extra credits can be used only once for any permanent government employment in New York State. If you want to have these extra credits added to your exam score, you must answer the questions now. You can waive the extra credits later if you wish. At the time of interview and appointment you will be required to produce the documentation, such as discharge papers, to prove that you are eligible for the extra credits.

1. Wish to claim War Time Veterans Credits, AND

2. Have NOT used veterans credits for appointment to a position in New York State or Local Government employment

YOUR ANSWERS MUST BE “YES’ TO BE ELIGIBLE FOR ADDITIONAL CREDITS.

I expect to receive or have already received, a discharge which was honorable or release under honorable circumstances from the Armed Forces of the United States. The “Armed Forces of the United States” means the Army, Navy, Marine Corps, Air Force and Coast Guard, including all components thereof, and the National Guard when in the service of the United States pursuant to call as provided by Law, on a full-time active

duty basis other than active duty for training purposes.

I am now serving, or have served, on an active duty basis other than active duty for training purposes during one or more of the following Time of War periods.

In the Armed Forces:

Aug. 2, 1990 to date when the Persian Gulf hostilities ends;

Feb. 28, 1961 to May 7, 1975;

June 27, 1950 to Jan 31, 1955;

Dec. 7, 1941 to Dec. 31, 1946;

Or earned the armed forces, navy, or marine corps expeditionary medal for service in:

(Panama) Dec. 20, 1989 to Jan. 31, 1990;

(Lebanon) June 1, 1983 to Dec. 1, 1987;

(Grenada) Oct. 23, 1983 to Nov. 21, 1983;

Or in the U.S. Public Health Service:

June 26, 1950 to July 3, 1952; July 29, 1945 to Sept. 2, 1945.

I am a United States citizen or an alien lawfully admitted for permanent residence.

To claim additional credits as a Disabled Veteran, you must also answer “YES” to this question:

YES NO

I am receiving payments from the U.S. Dept. of Veterans Affairs for a service connected disability rated at 10% or more incurred during a "Time of War" period listed above.

New York State Residency Requirement for Extra Credits as a War Time Veteran or Disabled Veteran: You will be required to provide proof of current New York State residency at time of appointment.

REMARKS:

ADDITIONAL EXAMINATION CREDITS PURSUANT TO CIVIL SERVICE LAW SECTION 85-a

If you are a child of a police officer or firefighter who was killed in the line of duty in the service of New York State, you may be entitled for additional examination credits pursuant to Civil Service Law Section 85-a. For further information, please contact the Department of Civil Service at (518) 473-9726.

PERSONAL PRIVACY PROTECTION LAW NOTIFICATION

The information which you are providing on this application is being requested pursuant to Section 50(3) of the New York State Civil Service Law for the principal purpose of determining the eligibility of applicants to participate in the examination(s) for which they have applied. This information will be used in accordance with Section 96(1) of the Personal Privacy Protection law, particularly subdivisions (b), (e), and (f). Failure to provide this information may result in disapproval of the application. This information will be maintained by the Office of the Mental Health. For further information, relating only to the Personal Privacy Protection Law, call (518) 457-9375. For exam information, call (518)457-2487 (press 2, then press 3); or toll free at 1-877-697-5627 (press 2, then press 3).

It is the policy of the State of New York to provide for and promote equal opportunity employment, compensation, and other terms and conditions of employment without discrimination on the basis of age, race, color, religion, disability, national origin, gender, sexual orientation, veteran or military service member status, marital status, domestic violence victim status, genetic predisposition or carrier status, or arrest and/or criminal conviction record unless based upon a bona fide occupational qualification or other exception.

It is the policy of the New York State Department of Civil Service to provide qualified persons with disabilities equal opportunity to participate in and receive the benefits, services, programs and activities of the Department, and to provide such persons reasonable accommodations and reasonable modifications as are necessary to provide such equal opportunity, including accommodations in the examination process. Further, it is the policy of the Department to provide reasonable accommodations for religious observers.

Common mistakes

Filling out the New York State Food Service Worker form can be straightforward, but many applicants make common mistakes that can lead to delays or disqualification. One frequent error is not reading the instructions carefully. The form includes important details about eligibility and submission that can significantly impact the application process.

Another common mistake involves incomplete information. Applicants often forget to fill in all required fields, such as their Social Security Number or contact information. An incomplete application may be disapproved, which could prevent a candidate from taking the exam.

Some individuals fail to provide accurate details regarding their employment history. This section requires careful attention, especially when answering questions about previous discharges from employment. Omitting or misrepresenting this information can lead to serious consequences, including disqualification.

Another issue arises when applicants do not disclose criminal history. If a candidate has ever been convicted of a crime or is currently facing charges, they must provide this information. Failing to answer these questions can significantly delay the application process and may result in loss of job opportunities.

In addition, many people overlook the requirement for reasonable accommodations. If an applicant needs assistance during testing, they must indicate this on the form. Neglecting to do so can result in a lack of necessary support on exam day.

Some candidates also misunderstand the eligibility requirements related to military service. To claim additional credits for wartime veterans, applicants must answer specific questions accurately. Misunderstanding these requirements can lead to missed opportunities for extra credits that could enhance their exam scores.

Moreover, applicants sometimes forget to sign and date the application. This is a crucial step, as an unsigned application is considered incomplete. A signature affirms that all information provided is true and can be subject to verification.

Lastly, failing to keep a copy of the submitted application can be detrimental. Keeping a record allows applicants to reference their information if needed and can help in case of any discrepancies during the review process.

More About Nys Food Service Worker

  1. What is the NYS Food Service Worker form?

    The NYS Food Service Worker form is an application used by individuals who wish to take the Food Service Worker 1 examination in New York State. This examination is open to the public and is necessary for those seeking employment in food service positions within various state agencies.

  2. How do I submit my application?

    To submit your application, you need to complete and sign the form, then send it to the facility Personnel Office where you want to take the examination. Make sure to check the examination announcement for specific locations and details on how to apply.

  3. What if I need reasonable accommodations for the exam?

    If you require reasonable accommodations, you should indicate this on your application. The announcement provides detailed information about the process for requesting accommodations, so be sure to review it carefully.

  4. What are the eligibility requirements for taking the exam?

    To be eligible for the Food Service Worker 1 examination, you must be authorized to work in the United States. Additionally, you must provide documentation that proves your identity and eligibility to work, as mandated by federal law.

  5. Are there any background checks involved?

    Yes, if you are selected for appointment after passing the examination, you will undergo a medical examination, fingerprinting, and a criminal background check. These steps are standard procedure to ensure the safety and integrity of the workplace.

  6. Can I claim extra credits as a veteran?

    If you are a wartime veteran or currently serving in the Armed Forces, you may be eligible for extra credits added to your exam score. This can enhance your chances of securing a position. Make sure to answer the relevant questions on the application to claim these credits.

  7. What happens if I don’t provide all requested information?

    Failing to provide complete information on your application can lead to disapproval. It is crucial to answer all questions thoroughly and accurately to avoid delays in the determination of your qualifications.

  8. What if I have a criminal record?

    If you have ever been convicted of a crime or are currently under charges, you must disclose this information on your application. Providing details is essential, as omitting this information could significantly impact your employment opportunities.

  9. How can I get more information about the exam?

    For additional information regarding the examination, you can contact the Department of Civil Service. They can provide guidance on the application process, examination dates, and any other inquiries you may have.

Misconceptions

Understanding the New York State Food Service Worker form can be challenging. Here are ten common misconceptions about the application process:

  1. Only specific agencies can accept my application. Many people believe that only certain agencies can process their application. In reality, you can submit your application to any facility Personnel Office where you wish to take the Food Service Worker examination, excluding the Office of Mental Health.
  2. I can take the exam as many times as I want. Some applicants think they can retake the Food Service Worker 1 written test multiple times. However, you can only take the test once every test form period.
  3. Accommodations are not available for the exam. Many assume that reasonable accommodations are not an option. In fact, you can request accommodations if needed, ensuring that everyone has a fair chance to take the test.
  4. My past employment history does not matter. Some individuals believe that their previous employment history is irrelevant. However, any discharge from employment, except for lack of work or medical reasons, must be disclosed as it can impact your eligibility.
  5. Criminal history automatically disqualifies me. A common misconception is that any criminal conviction will disqualify an applicant. While you must disclose any convictions, each case is evaluated individually.
  6. Only U.S. citizens can apply. Some think that only U.S. citizens are eligible for the position. In fact, lawful permanent residents can also apply, provided they meet other eligibility requirements.
  7. I don’t need to worry about my application being complete. Many applicants underestimate the importance of a complete application. Incomplete applications can lead to disapproval, so it’s crucial to provide all requested information.
  8. Extra credits for veterans are automatic. Some veterans believe they will automatically receive extra credits for their service. You must actively claim these credits on the application to benefit from them.
  9. Providing my Social Security number is optional. Some individuals think that sharing their Social Security number is not necessary. However, it is required for processing your application and verifying your identity.
  10. My privacy is not protected. There is a misconception that personal information provided on the application is not safeguarded. In reality, the information is protected under the Personal Privacy Protection Law, ensuring your data is handled responsibly.

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Key takeaways

When filling out the New York State Food Service Worker form, keep these key points in mind:

  • Complete all sections: Ensure every part of the application is filled out accurately. An incomplete application may lead to disapproval.
  • Eligibility requirements: You must be eligible to work in the United States and provide necessary documents to prove your identity and work eligibility upon appointment.
  • Background checks: Be prepared for a medical examination, fingerprinting, and a criminal background check if selected for appointment.
  • Extra credits for veterans: If you are a wartime veteran or disabled veteran, you may be eligible for additional credits on your exam score. Ensure you answer the relevant questions accurately to claim these credits.

Nys Food Service Worker: Usage Guide

Completing the New York State Food Service Worker form is a necessary step for those seeking to take the Food Service Worker 1 examination. This process involves providing personal information, confirming eligibility, and answering specific questions related to your background. Follow the steps below to ensure your application is filled out correctly.

  1. Print your name: Write your last name, first name, and middle initial in the designated spaces.
  2. Provide your Social Security Number: Enter your Social Security Number in the appropriate field.
  3. Fill in your address: Include your street number, apartment or P.O. Box, city or post office, state, and zip code.
  4. List your contact numbers: Provide your home and business phone numbers, including area codes.
  5. Indicate your need for accommodations: If you require reasonable accommodations for testing, check the appropriate box.
  6. Answer student loan questions: Indicate whether you have any outstanding student loans and if you are currently in default.
  7. Respond to additional questions: Answer the questions regarding employment history, military discharge, and criminal convictions. Provide details if you answer "yes" to any questions.
  8. Confirm eligibility: Acknowledge that you are eligible to work in the United States and understand the requirements for documentation.
  9. Affirm the accuracy of your information: Sign and date the application, affirming that all statements are true.
  10. Continue to the second page: If necessary, proceed to fill out the second page of the application.

After completing the form, ensure that all sections are filled out accurately. Submit your signed application to the facility Personnel Office where you wish to take the examination. Keep a copy of your application for your records.

⇓ Nys Food Service Worker PDF