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An equal opportunity employer, Victoria’s Secret Stores does not discriminate in hiring or terms and conditions of employment because of an individual’s race, color, religion, gender, gender identity, national origin, citizenship, age, disability, sexual orientation, marital status or any other protected category recognized by state, federal or local laws. Victoria’s Secret Stores only hires individuals authorized for employment in the United States. EMPLOYMENT APPLICATION Position Desired: ____________________________________ Schedule Desired: o Full Time o Part Time o Temporary/Seasonal Salary/Wage Expected:$ ___________ per _____________ Date Available: _________/_________/_________ _________/_________/_________ Date of Application Each inquiry on this application must be fully answered or completed. Otherwise, you will not be considered for employment. Last Name Present Street Address Previous Street Address Home Phone Number (including Area Code) First Name City City Email Address PERSONAL INFORMATION State State Middle Name Zip Zip Are you authorized for employment in the U.S.' o Yes o No How long have you lived there' Yrs. Mos. How long did you live there' Yrs. Mos. Are you under the age of 18' o Yes o No EDUCATION Type of School HIGH SCHOOL Name City COLLEGE Name City OTHER Name City State State State Name and Location of School Degree/Area of Study Number of Years Attended Graduated (Check One) o Yes o No o Yes o No o Yes o No List employment starting with your most recent position. Account for any time during this period that you were unemployed by stating the nature of your activities. If you have less than four places of employment, include personal references to be contacted. May we contact your current employer' o Yes o No Dates From: ______/______ Mo. Yr. To: Name Address Phone Name Address Phone Name Address Phone Name Address Phone Supervisor Final Supervisor Your Job Title Final Starting Supervisor Your Job Title Final Starting Supervisor Your Job Title Final Starting Name and Address of Employer Position Held and Supervisor Your Job Title List Major Duties Wages Starting Reason for Leaving EMPLOYMENT HISTORY ______/______ Mo. Yr. From: ______/______ Mo. Yr. To: ______/______ Mo. Yr. From: ______/______ Mo. Yr. To: ______/______ Mo. Yr. From: ______/______ Mo. Yr. To: ______/______ Mo. Yr. Have you ever been discharged or asked to resign from a job(s)' o Yes sor’s name(s), and circumstances of the discharge(s) or resignation(s): o No If yes, please provide details, including place(s) of employment, location(s), date(s), supervi- ___________________________________________________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________________________________________________________ REV 4/12 Academic and Professional Activities and Achievements, Awards, Publications or Technical-Professional Societies, indicate type or name. Exclude organizations which indicate race, color, gender, sexual orientation, gender identity, age, religion, disability, marital status, citizenship, national origin or any other protected category recognized by state, federal or local laws of its members. ACADEMIC AND PROFESSIONAL ACTIVITIES AND ACHIEVEMENTS Other skills applicable to position applied for (e.g. computer proficiency) What languages do you speak fluently' SPECIAL SKILLS Is there any additional information involving a change of your name or assumed name that will permit us to check your work record' Have you previously been employed by any Limited Brands, Inc. Division' o Yes o No List names of any person you know now employed by any Limited Brands, Inc. Division: At Victoria’s Secret Stores a good attendance record is an important part of every associate’s overall performance. Do you know of any reason you may not be able to comply with Victoria’s Secret Stores’ attendance policy' Employment Date(s) Division(s) Employed Position(s) Held MISCELLANEOUS This information is to facilitate contact in the event of any emergency and is not used in the selection process. Full Name Address PERSON TO CONTACT IN CASE OF EMERGENCY Phone SUN AM PM MON TUE AVAILABILITY WED THUR FRI SAT Start date: __________________ End date: __________________ Min # hours available weekly: __________________ o No o No Max. # hours available weekly: __________________ Christmas (week prior) o Yes o No Available start date: __________________ Will you be available to work: Thanksgiving (week) o Yes Christmas (week of) o Yes Other ______________________________________________ I hereby affirm that the information given by me on the application for employment is complete and accurate. I understand that any falsification or omission either on this application, or otherwise providing false information to the Company will be immediate grounds for dismissal, no matter when the falsification or omission is discovered. I authorize a thorough investigation to be made in connection with this application concerning my character, general reputation, personal characteristics, employment, education, and criminal record, whichever may be applicable for employment purposes. I understand this investigation may include personal interviews with third parties such as family members, business associates, financial sources, friends, neighbors, and others with whom I am acquainted. I further understand I have the right to make a written request within a reasonable period of time for complete and accurate disclosure of the nature and scope of the investigation. It is my understanding that as a prerequisite to consideration for employment, I must agree to submit to any post-employment examinations, physical or other, as the Company may lawfully require. The Company will pay the reasonable cost of any such examination which may be required. If I am hired, I agree that my employment and compensation can be terminated with or without cause, and without notice at any time, at the option of Victoria’s Secret Stores or myself. I understand that, unless modified in written agreement signed by both me and the Vice President of Human Resources or the President of Victoria’s Secret Stores, no representative of Victoria’s Secret Stores has the authority to make any agreement for employment for a specified time or to make any other agreement contrary to the foregoing. I have read and affirm as my own the above statements. ____________________________________________________________________ Applicant’s Signature ________________________ Date PLEASE READ THIS STATEMENT CAREFULLY APPLICANTS IN THE STATE OF MARYLAND ONLY Under Maryland law an employer may not require or demand any applicant for employment or any employee to submit to or take a polygraph, lie detector or similar test or examination as a condition of employment or continued employment. Any employer who violates this law shall be subject to criminal penalties and civil liability. ____________________________________________________________________ Applicant’s Signature ________________________ Date APPLICANTS IN THE STATE OF MASSACHUSETTS ONLY It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. Any employer who violates this law shall be subject to criminal penalties and civil liability. ____________________________________________________________________ Applicant’s Signature ________________________ Date APPLICANTS IN THE STATE OF CONNECTICUT ONLY I agree to be scheduled for less than four (4) hours of work on any given day at Victoria’s Secret Stores, provided the minimum daily pay in every instance shall be at least twice the applicable minimum hourly rate. ____________________________________________________________________ Applicant’s Signature ________________________ Date FAIR CREDIT REPORTING ACT DISCLOSURE AND AUTHORIZATION (CONSUMER REPORTS) DISCLOSURE OF INTENT TO OBTAIN CONSUMER REPORTS OR INVESTIGATIVE CONSUMER REPORTS For employment purposes in accordance with the Fair Credit Reporting Act and applicable law, Victoria’s Secret Stores (the “Company”) may obtain consumer reports, or investigative consumer reports, in connection with your employment application or from time to time during employment. Consumer reports include record checks conducted by consumer reporting agencies and may include driving records, criminal records, credit records, etc. Investigative consumer reports include investigations conducted by consumer reporting agencies through personal interviews (or through any means in California) on information as to character, general reputation, personal characteristics, or mode of living. You may make a written request for a summary of FCRA consumer rights and a disclosure of the nature and scope of an investigation. A disclosure of the nature and scope of such investigation is provided below. DISCLOSURE OF NATURE AND SCOPE OF INVESTIGATION FOR INVESTIGATIVE CONSUMER REPORT If we request an investigative consumer report in connection with your employment application, a consumer reporting agency will prepare such a report based on the following investigation: The agency may interview your former employers, business references, and/or personal references for information regarding prior employment, work experience and performance, reasons for employment termination, and information as to character, general reputation, personal characteristics, or mode of living. The agency may also conduct a records check of driving, criminal, credit, education, degrees, professional licenses, and/or certification records, depending on the job position. Such a report, or a credit report (if applicable), will be obtained from the following consumer reporting agency: General Information Services, P.O. Box 353, Chapin, South Carolina, 29036, 1-866-265-4917, www.geninfo.com. AUTHORIZATION I authorize the procurement of consumer reports and/or investigative consumer reports by the Company as part of the pre-employment background investigation and at any time during my employment. ______________________________________________________ SIGNATURE DATE __________________________________ ______________________________________________________ PRINT NAME IF YOU SEEK A COPY OF A REPORT, PLEASE FILL OUT ADDRESS, CITY, STATE AND ZIP: _______________________________________ STREET ADDRESS CITY ___________________________ _________ STATE ______________ ZIP California, Minnesota, and Oklahoma Applicants: If you wish to receive a free copy of any credit, consumer, or investigative consumer report obtained, please indicate by checking this box. q Minnesota applicants may make a written request to the consumer reporting agency for information on the nature and scope of a consumer report prepared. Maine Applicants: You may request and promptly receive from the consumer reporting agency a copy of any investigative consumer report prepared. Regarding such reports, you may request from us (and receive within 5 business days) the name, address, and telephone number of the consumer reporting agency’s nearest unit designated to handle inquiries. Massachusetts and New Jersey Applicants: You have the right to have a copy of the investigative consumer report upon request. New York Applicants: Upon your request, you will be informed whether or not a consumer report was requested, and if such a report was requested, the name and address of the consumer reporting agency furnishing the report. Oregon Applicants: Credit reports will not be obtained unless the position is one for which the Company is required to obtain a credit report as a condition of obtaining insurance or a surety or fidelity bond. Washington State Applicants: The Company may obtain a credit report for the reason that the employment position sought involves accounting for, handling, or having access to money and/or valuables. IF APPLICANT REQUESTS A COPY OF CONSUMER REPORT, MANAGER SHOULD CALL 1-800-765-7465. REFERENCE FORM Date: __________________ Candidate’s Name: ______________________________________ Phone: _____________________________________ If you are a former Limited Brands Associate, please verify the last four digits of your social security number:_______________ Please list three business references: • Two from a previous employer • One from a peer (co-worker) Supervisor 1 Name: _______________________________________________________________________________________________ Relationship: __________________________________________________________________________________________ Company: ____________________________________________________________________________________________ Position: _____________________________________________________________________________________________ Address: _____________________________________________________________________________________________ Work Phone: _____________________________________ Home Phone: ____________________________________ Cell Phone: _______________________________________ Length of time known'_______________________________ Supervisor 2 Name: _______________________________________________________________________________________________ Relationship: __________________________________________________________________________________________ Company: ____________________________________________________________________________________________ Position: _____________________________________________________________________________________________ Address: _____________________________________________________________________________________________ Work Phone: _____________________________________ Home Phone: ____________________________________ Cell Phone: _______________________________________ Length of time known'_______________________________ Peer Name: _______________________________________________________________________________________________ Relationship: __________________________________________________________________________________________ Company: ____________________________________________________________________________________________ Position: _____________________________________________________________________________________________ Address: _____________________________________________________________________________________________ Work Phone: _____________________________________ Home Phone: ____________________________________ Cell Phone: _______________________________________ Length of time known'_______________________________