From To Schools / Institutions / Universities attended Qualifications Obtained (e.g. Honours Degree) Languages (Please state languages and proficiency level i.e. excellent, good, fair, poor) Written : Spoken : 5. EMPLOYMENT HISTORY (Please list in chronological order & provide documentary evidence wherever applicable) Dates Organisation’s / Employer’s Last Drawn Basic Reason for Leaving Position held Name and Address Monthly Salary Service From To 6. CHARACTER REFEREES (Name 3 persons who are not your relatives) Name Occupation Years known Address / Tel Contact / Address 7. OTHER INFORMATION Please answer the following questions. If the answer is 'Yes' to any of the items below, please give details on a separate sheet of paper. Yes No a Have you any criminal record? Yes No b Have you ever been dismissed, discharged or suspended from employment? c Have you ever had, or are you suffering from any: Yes No - physical impairment? Yes No - disease? Yes No - mental illness? Yes No d Are you currently serving a bond or a moral obligatory service? Yes No e Do you have any relative or friend presently working in the University? If yes, please state his/her name, relationship and department:______________________________________ ________________________________________________________________________________________ 8. PRIVACY STATEMENT
From To Schools / Institutions / Universities attended Qualifications Obtained (e.g. Honours Degree) Languages (Please state languages and proficiency level i.e. excellent, good, fair, poor) Written : Spoken : 5. EMPLOYMENT HISTORY (Please list in chronological order & provide documentary evidence wherever applicable) Dates Position held Organisation’s / Employer’s Name and Address Last Drawn Basic Monthly Salary Reason for Leaving Service From To 6. CHARACTER REFEREES (Name 3 persons who are not your relatives) Name Occupation Years known Address / Tel Contact / Address 7. OTHER INFORMATION Please answer the following questions. If the answer is 'Yes' to any of the items below, please give details on a separate sheet of paper. a Have you any criminal record? Yes Yes Yes Yes No No No No b Have you ever been dismissed, discharged or suspended from employment? c Have you ever had, or are you suffering from any: - physical impairment? - disease? - mental illness? Yes No d Are you currently serving a bond or a moral obligatory service? Yes Yes No No e Do you have any relative or friend presently working in the University? If yes, please state his/her name, relationship and department:______________________________________ ________________________________________________________________________________________ 8. PRIVACY STATEMENT
Research%20Staff%20Application%20form.docx