Application Form Please return for the attention of the Manager

Freedom Sportsline Ltd,

P.O. Box 6352, London W1A 2BF, United Kingdom (hereinafter referred to as the Company)

Please complete this application fully. If you have any difficulties in doing so please do not hesitate to contact us.

Personal All information contained in this document will remain strictly confidential

Store (Location): Date:

Position Applied for: How did you hear of this Position?

Title: Mobile Phone No.:

Surname: Home Phone No.:

First Names: Work Phone No.:

Are you available to work weekends and evenings? Yes / No

Current Address:
Postcode:

Permanent Address: (if different to current address)

Email Address:

Identification
All candidates must provide proof of eligibility for employment in the country they are applying for and therefore submit
appropriate documentation when requested.

Are you legally entitled to work in the country that you are applying for? Yes / No

General
Do you have any relatives/partners employed by Foot Locker? If yes, give positions, locations and names.

Position: Location: Name:

Have you ever been convicted of a criminal offence? If yes, please tell us of any convictions/offences, which are not
“spent” under the Rehabilitation of Offenders Act 1974.
Work History Foot Locker
Have you previously worked for Foot Locker? If yes, give dates, position and location.

Dates: From To Location:

Mobility
Vacancies may exist in other Foot Locker stores. Please list locations/areas where you would be willing to work:

Education (Diploma/Certificate/Degree earned/Professional Certification)

School (High School, University/College) Year Degree, Diploma or Certificate received

Professional or other qualifications, including membership of professional societies and details of other specialist training,
knowledge or experience relevant to retail and/or customer service:

Employment History
Please detail your employment history starting with your current or most recent employer. If you have any gaps in your
employment history due to unemployment, please note as well.

Company Name: Dates

Telephone Number: From:
Address: To:

Nature of Employer’s Business: Give 3 main responsibilities in your current role:

Your Job Title:
Supervisor’s Name:
State notice period:
Dates of any planned holiday arrangements:
When would you be able to start work?

Describe two achievements you have made in your current role:

 Company Name: Dates
Telephone Number: From:
Address: To:

Nature of Employer’s Business:

Your Job Title:
Supervisor’s Name:

Give 3 main responsibilities in this role: Describe two achievements you have made in this role:

Company Name: Dates

Telephone Number: From:
Address: To:

Nature of Employer’s Business:

Your Job Title:
Supervisor’s Name:

Give 3 main responsibilities in this role: Describe two achievements you have made in this role:

Additional Information
Tell us about a time when you provided extraordinary customer service by delivering the unexpected.

Describe the most difficult customer service situation you have experienced and how you handled it.

Tell us about a time when your job required you to coordinate your work with others. What did you like about it? What did you not like?

Please specify the languages that you speak comfortably:

References
Please provide names and addresses of your last two employers. If you don’t have two employers, School/University
references are acceptable.

Name: Name:
Name of Company/School: Name of Company/School:
Position: Position:
Address: Address:

Telephone Number: Telephone Number:

Declaration
I declare that the information I have supplied in this form is true and complete. I understand that if it is subsequently discovered
that any statements are false or misleading, I will be liable to have my application disqualified or subsequently may be liable to
be dismissed from employment by the Company, where applicable by law. I further agree that the Company may make contact
with any personal referee or past employer identified in this application for means of obtaining satisfactory references and that I
consent to these references being disclosed to the Company.

Personal Data Notice and Consent

I hereby consent that personal data collected via this Application Form may be processed by the Company for the
purpose of managing my employment application as well as to create a database regarding possible future employment
opportunities at Foot Locker. The personal data will be used by the Company and/or affiliated Foot Locker companies in
the context of recruitment and selection, and the processing may include any manual or automated measures taken with
the personal data, including but not limited to gathering, registration, storing, changing and disclosing the data to related
Foot Locker companies.

I hereby also consent that the Company may transfer the personal data to Foot Locker companies located outside the
European Union.

In case the application process would result in employment at Foot Locker, the data of the Application Form will be
transferred to the personnel file. In case of an unsuccessful application, I consent to the fact that the data may be stored
by the Company for a period of up to 6 months following completion of the application process.

By filling in this Application Form, I explicitly authorize the Company to process the personal data it contains for the
purposes described above (including the processing of data in connection with contact with my previous employer). I am
aware that I have the right, in accordance with the applicable legislation, to review, access and correct my personal data.

Place and Date: Signed:

Equal Opportunities Monitoring Form
The Company is committed to ensuring that applicants from all sections of the community are treated equally
and not discriminated against on the grounds of gender, colour, race, nationality, marital status, religion or
belief, sexual orientation, disability or age. This form assists us in monitoring who is applying for employment
with us and our progress towards identifying any barriers to diversity among our workforce. This form will be
separated from your application on receipt. We would be grateful if you would fill in this form and return it with
your application. You are not obliged to answer all the questions but the more information you supply, the more
effective our monitoring will be. All information supplied will be treated in the strictest confidence.

1.1 Please state which job you have applied for and the date of your application.
Job applied for:...................................................... Date of application:................................................

1.2 What is your gender (please tick)?

Male Female
If you are currently undergoing the process of gender reassignment, please tick your future gender.

1.3 How would you describe your nationality and/or ethnicity (please tick)?
A. White:
British - English, Scottish or Welsh Irish
Any other white background

B. Black or Black British:

Caribbean African
Any other black background

C. Chinese or other ethnic group:

Chinese Any other ethnic group

D. Mixed race:
White and Black White and Black African
White and Asian Any other mixed background

E. Asian or Asian British:

Indian Pakistani
Bangladeshi Any other mixed background

1.4 Is your age between (please tick):

16-24 25-29
30-39 40-49
50-59 60 or over
1.5 How would you describe your religion?
My religion is:
Prefer not to say I am not religious

1.6 [The Disability Discrimination Act 1995 (DDA) defines a disability as a “physical or mental impairment which has a
substantial and long-term adverse effect on a person’s ability to carry out normal day-to-day activities”. An effect is long-term
if it has lasted, or is likely to last, over 12 months. Do you consider yourself to have a disability under the DDA (please tick)?]
Yes No
Used to have a disability but have now recovered
Don’t know Prefer not to say

1.7 [If you answered “Yes” to question 1.7, please give brief details of your condition and please indicate whether you may
require any adjustments to enable you to attend and participate in an interview or to carry out any selection tests.] Disabled
applicants are invited to contact the personnel office in confidence at any point during the recruitment process to discuss
steps that could be taken to facilitate attendance and participation at an interview or in order to overcome any operational
difficulties presented by the job. Brief details of condition including whether mental physical):
or
Adjustments required for interview (including, for example, induction loop/radio aid/speech-to-text reporter/BSL interpreter/
other):
Adjustments required for job:

1.8 Please give details of any other special requirements we may need to be aware of in order to facilitate your attend-
ance at an interview. For the purposes of compliance with the Data Protection Act 1998, I hereby confirm that by completing
this form I give my consent to Foot Locker processing the data supplied above in connection with monitoring compliance with
its equal opportunities obligations and policy. I also agree to the storage of this information on manual and computerised files.

Signed: Dated: