Please read the University’s Guidelines for the awarding Visiting Titles before completing this form. The guidelines are available online here:https://www.otago.ac.nz/administration/policies/otago003329.html. Details of Person being Appointed Full Name (Including title) Mailing Address Has this person Work Permit Expiry Date Yes previously (if applicable, attached a ____/____/_____ been employed by the No copy) University of If yes, what dates? From: To: ____/____/_____ ____/____/_____ Justification for awarding Visiting Title at level recommended: Details of Position Department Visiting Title Role/Contribution to the University Term of Appointment Date of Commencement Finish Date ____/____/_____ ____/____/_____ (6-week to 1-year term) Funding Details The fellowship may be with or without emolument. If a payment is recommended, fill in this section. Recommended payment (per annum) $ _ _ . _ _ . _ _ _ . _ _ _ _ . _ _ Account GL Number _ _ _ _ _ _ . _ _ . _ . _ _ . _ _ _ _ . _ _ PL Approval Head of Department Date ____/____/_____ Signature Dean of School Date ____/____/_____ Signature
Please read the University’s Guidelines for the awarding Visiting Titles before completing this form. The guidelines are available online here:https://www.otago.ac.nz/administration/policies/otago003329.html. Details of Person being Appointed Full Name (Including title) Mailing Address Work Permit Expiry Date (if applicable, attached a copy) ____/____/_____ Has this person previously been employed by the University of Yes No If yes, what dates? From: ____/____/_____ To: ____/____/_____ Justification for awarding Visiting Title at level recommended: Details of Position Department Visiting Title Role/Contribution to the University Term of Appointment Date of Commencement ____/____/_____ Finish Date (6-week to 1-year term) ____/____/_____ Funding Details The fellowship may be with or without emolument. If a payment is recommended, fill in this section. Recommended payment (per annum) $ Account Number GL _ _ . _ _ . _ _ _ . _ _ _ _ . _ _ PL _ _ _ _ _ _ . _ _ . _ . _ _ . _ _ _ _ . _ _ Approval Head of Department Signature Date ____/____/_____ Dean of School Signature Date ____/____/_____
otago697063.docx