Personal Particulars Form (Faculty Appointment)

This form may take you 10 minutes to complete.

You will need the following information to complete the form:

 Passport number and passport details (applicable to Non-Singapore

Citizens/Residents)
 UIN number and date of issue (applicable to SPRs)
 Identity card number (applicable to Singapore/Malaysia Citizens and SPRs)

Updated By: NSS HR

Date: 1 Nov 2017
Personal Particulars Form (Faculty Appointment)
Please refer to http://www.ntu.edu.sg/ohr/career/submit-an-application/Pages/Faculty-Positions.aspx for guidelines on submission of faculty
application. Please submit your completed form with full curriculum vitae to: NTU Shared Services - Human Resources, Nanyang
Technological University, Student Services Centre, Level 5, 42 Nanyang Avenue, Singapore 639815.
1. GENERAL INFORMATION
Position applying/considered for :       School :      

Please indicate where you came to know about the position being applied for:
Advertisement in Newspapers / Journals / Others Personal Contacts. NTU Website. Others.
Name of publication :       Please specify :      

Are you currently applying for a position in another School in NTU? If yes, please specify School.
No Yes      
2. PERSONAL PARTICULARS
Full Name as in Passport / Identity Card : Nationality :     
Surname:       First and Middle (if any) name(s):      
Country of Birth :      
Preferred Name*:      

Home / Postal Address :       (Office):       (Mobile):      

(Home):      
Date of Birth :      Email Address:      
(dd/mm/yyyy)
Present Appointment :      For Non-Singapore Citizens/Residents only

Name & Address of Present Employer:       Passport No. : Date of Issue :
(dd/mm/yyyy)

Place of Issue : Date of Expiry :

(dd/mm/yyyy)

For Singapore Permanent Resident (SPR) only

Please attach a copy of Entry Permit and indicate :
Date of Present Appointment :       Date SPR issued :       UIN :      
(dd/mm/yyyy) (dd/mm/yyyy)

Present Annual Base Salary :       Other Allowance/Bonus :       For Singapore /SPRs/Malaysia Citizens only (pls indicate)
(please specify currency)

If Resigning from present appointment Identity Card No.:      

appointed: Taking leave from present appointment Colour : Pink Blue
Duration of Leave :      

3. 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. Do you have any criminal record? Yes No
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
- 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(s) or friend(s) presently working in NTU? If yes, please state
his/her name, relationship, and school/department.

I declare that all the particulars given in this form and attached curriculum vitae are true to the best of my knowledge and belief,
and I have not wilfully suppressed any material fact. I understand that any misrepresentation or omissions of information will
render me liable to disqualification, or, if appointed, for dismissal.

I acknowledge that I have read and that I consent to the Personal Data Privacy Statement.

DATE :       SIGNATURE :      

* Faculty may request that their "Preferred Names" be different from their legal names of record. The "Preferred Name" is used for services
such as email, display in directories, etc. NTU reserves the right to deny any preferred name that is deemed inappropriate.

Updated By: NSS HR

Date: 1 Nov 2017