To which Acme do you wish to apply?

Choose a location or department: NEW! PARMA LOCATION 1835 W. Market St., Akron, Ohio 2420 Wedgewood Dr., Akron, Ohio 116 W. Streetsboro Rd., Hudson, Ohio 3200 Greenwich Rd., Norton, Ohio 1709 State Route 59, Kent, Ohio 2226 State Rd., Cuyahoga Falls, Ohio 600 South Ave., Tallmadge, Ohio 2630 Bailey Rd., Cuyahoga Falls, Ohio 3235 Manchester Rd., Akron, Ohio 3979 Medina Rd. (Rt. 18) Akron, Ohio 1474 N. Main St., N.Canton, Ohio 4445 Kent Rd., Stow, Ohio 2147 East Ave., Akron, Ohio 2905 Whipple Ave. NW, Canton, Ohio

General Information:

*Last Name *First Name Middle *Street Address *City *State *Zip Code * Where you previously employed by us? Yes No If yes, where? When? Position Desired: Deli (18 years or older only) Meat (18 years or older only) Bakery Produce Grocery/Stock Cashier/Packer Night Crew * Are you available for full time work? Yes No If not, what hours can you work? * Are you legally eligible for employment in the U.S.? Yes No * Do you have reliable transportation to work? Yes No * Will you work at any of our locations? Yes No

Date: July 31, 2010 - 8:49am * Phone Social Security Number * Are you willing to work evenings, weekends and holidays? Yes No * When can you begin work with us? * Acme is a "Smoke-Free" company. Can you work in this enviroment? Yes No

Education

Previous Employment

Please provide a complete and accurate history (full time and part time). Begin with your present employer or most recent employer.

Military Experience

Other

References

Conditions of Employment

Customer Service *Always wear a smile. *Always be friendly to our customers. *Always make the customer feel welcome. *Always treat the customer with respect. *Always thank the customer for shopping with us.

Personal Appearance *Maintain Acme standards for grooming. *Maintain Acme standard Dress Code. *Wear your Acme name badge at all times.

Attendance/Punctuality *Always report to work when you are scheduled. *Always be on time. *If you are ill, always call the store at least 4 hours prior to start of shift.

* Will you be able to comply with all of the requirements listed? Yes No

PLEASE READ CAREFULLY BEFORE SIGNING:

I certify that the statements made on this application are true and complete and I understand that any false or misleading statements on my application or during my interview are grounds for dismissal. I voluntarily give the Fred W. Albrecht Grocery Company permission to investigate my past employment and background and agree to cooperate in such investigation and release all persons and organizations supplying such information from any liability.

If hired, I agree to comply with the rules and regulations of the Company and understand that no representative of the Company other than the President has the authority to enter into an agreement for employment with me and that any such agreement must be in writing and property signed to be valid. I understand that i may be required to submit to a physical examination and/or drug screening.

Equal Opportunity Employer Information

The Fred W. Albrecht Grocery Company is an equal Opportunity Employer committed to a diverse work force. To that end, we invite you to voluntarily provide responses to the following requests for information. Your answers - or your failure to answer - will not affect your chances for being offered employment. This form will be kept strictly confidential and will not be retained with your application. The information provided will only be for equal opportunity purposes and record keeping.