albie’s

APPLICATION FOR EMPLOYMENT

PRE-EMPLOYMENT QUESTIONNAIRE
EQUAL OPPORTUNITY EMPLOYER

Albie's Food Products, LLC
1534 O'Rourke Blvd
Gaylord, MI 49735

Applicant Information

Date: 2026-09-02

Last Name:

First Name:

M.I. (optional):

Street Address:

Apartment/Unit # (optional):

City:

State:

Zip:

If applying for a driving position, do you have a valid Driver's License? Yes No N/A

Phone:

Email (optional):

Preferred Method of Contact: Phone Email

Alternative Phone (optional):

Date Available:

Desired Salary (optional):

Are you looking for part-time or full-time employment? Part-time Full-time

Which shift would you prefer? 1st Shift 2nd Shift 3rd Shift

Position Applied for:

Can you, after employment, submit proof of your legal right to work in the United States? Yes No

Have you ever worked for this company? Yes No

High School (optional):

Did you graduate? Yes No

Degree (optional):

College (optional):

Did you graduate? Yes No

Degree (optional):

Will you be able to perform the tasks of this job as described with or without reasonable accommodation? Yes No

Are there any tasks you will not be able to perform?

Military Service

Branch (leave blank if not applicable):

From:

To:

Rank at Discharge:

Type of Discharge:

If other than honorable, explain:

Criminal History

Have you ever been convicted of a crime other than a minor traffic violation? Yes No

Previous Employment

Previous Employer 1

Company:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary ($):

Ending Salary ($):

Responsibilities:

Start Date:

End Date:

Reason for Leaving:

May we contact your previous supervisor for a reference? Yes No

Previous Employer 2

Company:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary ($):

Ending Salary ($):

Responsibilities:

Start Date:

End Date:

Reason for Leaving:

May we contact your previous supervisor for a reference? Yes No

Previous Employer 3

Company:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary ($):

Ending Salary ($):

Responsibilities:

Start Date:

End Date:

Reason for Leaving:

May we contact your previous supervisor for a reference? Yes No

Professional References — please list three references

Reference 1

Full Name:

Company:

Phone:

Address:

Reference 2

Full Name:

Company:

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Address:

Reference 3

Full Name:

Company:

Phone:

Address:

Additional Information

Additional information — certificates, licenses, skills, professional memberships, etc. (optional):

Disclaimer and Signature

I certify that the facts contained in this pre-employment application are true and complete to the best of my knowledge and understand that, if employed; falsified statements on this pre-employment applications are grounds for dismissal.

I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period or to make any agreements for employment for any specified period or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.

Date: 2026-09-02

Signature of Applicant:

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