COVER SHEET: ACADEMIC STAFF APPLICATION GRT/08/18A
UNIVERSITY of KURDISTAN-HAWLER
Return to: Head of Administrative Services, University of Kurdistan-Hawler, 30 Meter Street, Erbil
This form must be completed in full by all applicants. Please use typescript or write in block capitals using black ink. All information is treated in confidence.
Post applied for:Applicant No:
Surname:
First Name:
Home or Permanent Address: / Current Contact Address (if different):
Line 1
Line 2
Line 3
City
Country
Zip/Postal code
Telephone number
(inc. international code)Mobile Number
Email Address
Fax Number
Give date of availability to start work? (dd/mm/yy) / ___/___/___
DECLARATION:
I certify that the information above and in the attached documents is correct. I understand that any deliberate falsehood could lead to termination of contract; and that any offer of employment is subject to the receipt of references and employment visa.
NAME: (caps) ______
SIGNATURE: ______DATE______
APPLICATION FORM: ACADEMIC STAFF APPOINTMENT GRT/08/18A
UNIVERSITY of KURDISTAN-HAWLER
Return to: Head of Administrative Services, University of Kurdistan-Hawler, 30 Meter Street, Erbil
This form must be completed in full by all applicants. Please use typescript or write in block capitals using black ink. All information is treated in confidence.
Post applied for:Applicant No:
Surname:
First Name:
Title (Prof/Dr./Mr/Ms
Birth Date (dd/mm/yy) / ___/___/___Home or Permanent Address: / Current Contact Address (if different):
Line 1
Line 2
Line 3
City
Country
Zip/Postal code
Telephone number (inc. international code)
Mobile NumberEmail Address
Fax Number
Country of Birth
Passport NationalityPassport Number
Passport Place of Issue
Passport Expiry (dd/mm/yy) / ___/___/___
Visa type
Visa NumberVisa Expiry (dd/mm/yy) / ___/___/___
ACADEMIC AND PROFESSIONAL QUALIFICATIONS We will verify your qualifications with the issuing Institute.
Qualification / Date
Awarded / Awarding Body* / Qualification Level / Subject/s
PROFESSIONAL DEVELOPMENT (courses, training, membership of professional associations, etc)
Type / Date / Institution /
Comments
EMPLOYMENT HISTORY (Begin with your most recent employer and continue on a separate sheet if necessary. Explain any break in employment exceeding three months.)Date
From / Date
To / Employer Name and Address / Position Held / Main Duties
CURRENT OR MOST RECENT SALARY (Indicate monthly levels and currency)
Gross monthly salary / Housing Allowance / Child Allowance / Transport Allowance / Medical Benefits / Other benefits
LANGUAGE SKILLS (Indicate your proficiency level using a scale of 1 – 5, where 1= excellent, 5 = basic )
Name of Language / Oral Skills / Written Skills / Reading skills
Native Language
/Second Language
/Third Language
MEDICAL: Please advise of any serious illness/conditions and any treatment of medication you are receiving
REFEREES: Appointment is subject to the receipt of satisfactory references, one of which must be from your current or most recent employer.
Referee 1 / Referee 2 / Referee 3
Name and Title
Position Held
Institution/Organisation
Contact Address
Line 1
Line 2
Line 3
City
Country
Zip/Postal code
Email Address
Fax Number
Telephone-Personal
Telephone-Business
May referee be contacted? (Yes/No)
Prepare and attach the following essential documents to your application:
1. Curriculum Vitae
2. List of Publications3. Current Research Interests
4. Specialist Teaching Interests
5. Statement of how your qualifications and experience make you suitable for this post
6. Statement of contribution you expect to contribute to the University of Kurdistan-Hawler.
DECLARATION: I certify that the information above and in the attached documents is correct. I understand that any deliberate falsehood could lead to termination of contract; and that any offer of employment is subject to the receipt of references and employment visa.