Groupia Ltd Application Form Please take the time to complete and submit this application form. We will then review this and be in touch to let you know if we wish to invite you in for an interview. OK Question Title * 1. Application for employment as: OK Question Title * 2. Details Name Address Address 2 City/Town ZIP/Postal Code Country Email Address Phone Number OK Question Title * 3. Education and Training Where From To Qualification/Training Grade OK Question Title * 4. Education and Training Continued Where From To Qualification/Training Grade OK Question Title * 5. Employment History Present Employer Address Job Title Salary Date Employed From Date Employed To OK Question Title * 6. Please give a brief overview of your duties and responsibilities in your current role: OK Question Title * 7. Reason for wanting to leave: OK Question Title * 8. Employment History Continued Previous Employer Address Job Title Salary Date Employed From Date Employed To OK Question Title * 9. Please give a brief overview of your duties and responsibilities in your role: OK Question Title * 10. Reason for leaving: OK Question Title * 11. Please tell us about any other jobs you have done and about the skills you used and/or learned in those jobs: OK Question Title * 12. Please tell us why you have applied for this job and why you think you are the best person for the job: OK Question Title * 13. Do you consider yourself to have a disability? Yes No OK Question Title * 14. Please tell us if there are any ‘reasonable adjustments’ we can make to assist you in your application or with our recruitment process OK Question Title * 15. Please tell us if there are any dates when you will not be available for an interview OK Question Title * 16. Can you give me any examples of where you’ve had to put in effort to achieve a result you were after? OK Question Title * 17. How did you feel about it? OK Question Title * 18. What are your top 3 most important goals? 1. 2. 3. OK Question Title * 19. If your best friend was asked to describe you, what would they say? OK Question Title * 20. What is your proudest achievement to date? OK Question Title * 21. Name 3 companies you admire and why? 1. 2. 3. OK Question Title * 22. What do you think it takes to be a market leader? OK Question Title * 23. Tell me about a recent purchase you were pleased with at a service level? OK Question Title * 24. What made it stand out? OK Question Title * 25. What do you hate doing? OK Question Title * 26. What do you think influences the modern consumer? OK Question Title * 27. What do you think it takes to be successful in the position you are applying for? OK Question Title * 28. I confirm that to the best of my knowledge the information I have provided on this form is correct and I accept that providing deliberately false information could result in my dismissal. Yes No OK Question Title * 29. Please electronically sign and date below Signature Date OK DONE