PERSONNEL RECORD FORM
DEPARTMENTAL EMERGENCY CONTACT FORM
|NAME: (Please include your title) |
|YOUR CONTACT ADDRESS (IN GLASGOW): |
| |
| |
|TELEPHONE NUMBER: |
| |
|DATE OF ENTRY TO DEPARTMENT: |
| |
|EXPECTED CONTRACT END DATE (if applicable): |
|POSITION: |RESEARCH GROUP: |
|ROOM NO.: |TELEPHONE NUMBER: |
|LOCAL CONTACT IN EMERGENCY | |
| |RELATIONSHIP to you |
| |(Please indicate if this person is your NEXT OF KIN): |
| |
|NAME: |
| |
|ADDRESS: |
| |
| |
|TELEPHONE NUMBERS (home/ work/mobile): |
|OTHER CONTACT IN EMERGENCY |RELATIONSHIP to you |
| |(Please indicate if this person is your NEXT OF KIN): |
| |
|NAME: |
| |
|ADDRESS: |
| |
| |
|TELEPHONE NUMBER.: |
Notes
In accordance with DPA principles, please note the following in relation to this form and the data held within it:
1 The emergency contact data will be used only for emergency purposes e.g in the event of an accident in the workplace.
2 You should notify the individual(s) you have named above that you have provided us with this information and we will hold this information on file whilst you are employed in the Department.
3. The emergency contact data will only be disclosed in emergency situations to appropriate 3rd parties, e.g ambulance service, the NHS and the police, in your immediate health or safety interests.
4. It is your responsibility to notify the Departmental Office as soon as possible should any of your contact details change.
Completion of this form is voluntary, however you are required to maintain your contact details on HR Self Service at
Information on the Data Protection Act can also be found at and
|I, , agree to the conditions stated above. Date: |
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