Food Safety Manager Class/Exam Registration

Food Safety Exam Registration
You must complete the State Food Safety training PRIOR to the exam. If you are not 100% done with the online training before class will be removed from the exam schedule. Variance hours and rate change will be applied when an exam is completed with a passing score, both submitted by the Development Team. DO NOT complete payroll variances for any training.

Upon the sucessfull completion of an exam, a member of the admin team will submit 10 hours of Payroll Variance Hours (includes online training & exam).*

*These are the hours that will be paid, regardless of time spent.
Employee Name*

First NameLast Name
What area is your restaurant located in?*

Beloit AreaRockford AreaHuntley Area
Beloit Area
Rockford Area
Huntley Area
Employee’s Email (used for State Food Safety Account)*
Please enter your phone number so we can contact you directly with class/exam information.*

Area CodePhone Number
Birthday*
Type your birthday MM/DD/YYYY
Is this a new certification or a re-certification?*

New CertificationRe-Certification
Which date/location would you like to attend class*

Rockford - Tuesday, February 10th; 10am-12pm
Once user and password have been received, log on at statefoodsafety.com Please read through both of these documents as they pertain to the class and successful registration.
I have read both documents and understand and agree to comply with the above statements. I understand that any activities that go against company policies, will have corrective action taken, including, but not limited, to disciplinary action ranging from a warning to termination. While attending this training or class I will present myself and the Bucciferro Organization in a professional manner.*

YesNo
Signature

Clear
Class sizes is limited. Classes are generally the second Monday of the month. The Iron Arch Office will send the GM and the student a confirmation email detailing what session they will be attending. This will come at least 2 weeks prior to class.
Should be Empty:

Once user and password have been received, log on at statefoodsafety.com Please read through both of these documents as they pertain to the class and successful registration.

Class sizes is limited. Classes are generally the second Monday of the month. The Iron Arch Office will send the GM and the student a confirmation email detailing what session they will be attending. This will come at least 2 weeks prior to class.