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UNIVERSITY OF SALFORD STAFF RECORD FORM 1. Personal Details: Title........…...…Forenames..........................…............... Surname.............…..……...........…..…... Male/Female Marital Status....................…….................. Date of Birth........……..….......…...…… Home Address......................................................................................……………….……................... ...............................................................……................... Post Code..............…………............ Home 'Phone No...................…….......................... National Ins No..........….....……….…................ Ethnic Origin..............................………................. Nationality.......……………………...................… (Please choose from the Census 2001 Ethnicity categories overleaf) Disability Status - Disabled/Not Disabled Emergency Contact..................................……...... Phone Number...…………..............................… Contact Address............................................................................…………………….......................…. 2. Degrees/Professional Qualifications: Degrees: Letters Awarding Body Subject Year of Award 1...........……........ ................................ .....................….............…….............. ………………... 2................……... ................................ .....................…..........................……. ………………... 3................……... ................................ .......................…........................……. ………………… Professional Qualifications: 1...........……........ ................................ .....................….............…….............. ………………... 2................……... ................................ .....................…..........................……. ………………... 3. Previous Employer:...............….........…............. Position held..............…………......................... 4. Details of Appointment: School/RI............................……….….................... Date of Appointment....................….…………... Title of Appt..............................………................... Salary Grade..........................…….………......... Full time/Pt...................................……….............. Permanent/Temporary/Casual...........……....... If sponsored by Research Council or other organisation, name of sponsoring body:......………................ Type of Superannuation: USS/LGSS/Personal Pension........................................………............. _____________________________________________________________________________ For Office Use Personnel No:...................………..….…….…. Ethnicity Census 2001 Ethnicity Categories: White - British White - Irish Other White background Black or Black British - Caribbean Black or Black British - African Other Black background Asian or Asian British - Indian Asian or Asian British - Pakistani Asian or Asian British - Bangladeshi Chinese or Other Ethnic background - Chinese Other Asian background Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Other Mixed background Other Ethnic background
