RESEARCH OR POST-DOC APPOINTEE
CONFIDENTIALITY AGREEMENT
OVPRI – April 2015
This form must be completed and signed by the incumbent and submitted with the REQUEST FOR A RESEARCH
OR POST-DOC APPOINTMENT form. Please note that requests for appointments not accompanied by a signed
Confidentiality Agreement will not be processed.
APPOINTEE: _______________________________________________________________________________
TITLE: _____________________________________________________________________________________
List the appointment title as it appears on the REQUEST FOR A RESEARCH OR POST-DOC APPOINTMENT form (e.g. Research Assistant,
Research Associate, Post-Doc, etc.).
SUPERVISOR: ______________________________________________________________________________
DEPARTMENT: _____________________________________________________________________________
APPOINTMENT FUNCTIONS AND RESPONSIBILITIES:
List the appointment functions and responsibilities as they appear in the Position Overview section of the POSITION SUMMARY form.
APPOINTMENT DURATION: _______________ to _______________ WEEKLY WORK HOURS: _________
STIPEND/RATE OF PAY: ________________ VACATION ENTITLEMENT: ___________________________
BENEFITS:
N/A
Paid by Incumbent
Paid from Grant
List the appointment duration, weekly work hours, stipend/rate of pay, vacation entitlement, and benefit details as they appear on the
REQUEST FOR A RESEARCH OR POST-DOC APPOINTMENT form.
APPOINTEE INFORMATION (TO BE COMPLETED BY THE INCUMBENT)
Are you legally eligible to work in Canada?
Yes
No
Do you currently hold another position at the University of Windsor?
Yes
No
If you have answered yes, list all positions that you currently hold (including Teaching Assistantships/Graduate Assistantships) below. Enter your
title, name of your supervisor, the department, and the number of hours you work weekly.
1. ________________________________________________________________________________________
2. ________________________________________________________________________________________
Are you being hired as a Post-Doc?
Yes
No Date of PhD completion: _________________________
If you have answered yes, attach a photocopy of your PhD certificate to this form.
Are you currently registered as a student/taking courses at the University of Windsor?
Yes
No
APPOINTEE DECLARATION (TO BE COMPLETED AND SIGNED BY THE INCUMBENT)
I acknowledge that the faculty member and the University of Windsor have ownership of intellectual
property resulting from my employment work subject to University policies, and obligations to the
research funding agencies, institutions, and/or companies.
I acknowledge that I am expected to maintain confidentiality of information, programmes, and data
that may be developed in my work or which I may have access to during the course of my
employment.
I declare that all information provided on this confidentiality agreement is true and accurate.
Accepted:
_____________________________ _________________________________ ________________________
