RESEARCH OR POST-DOC APPOINTEE
CONFLICT OF INTEREST FORM
OVPRI April 2015
This form must be completed and signed by the supervisor and submitted with the REQUEST FOR A RESEARCH
OR POST-DOC APPOINTMENT form if the appointee is a relative.
University of Windsor Policy C1: Conflict of Interest or Commitment, 7.0 Favouritism in Employment states:
"The university takes every precaution to guard against favouritism of every kind in hiring. Faculty and staff
members must be scrupulously fair and honest in ensuring that positions are well advertised and that
appointments are offered always to the best-qualified available candidates. In so doing, however, the university
acknowledges that, occasionally and in unique circumstances, there are cases in which, to fulfil the mission of
the university, potential conflicts of interest may arise.
When a faculty or staff member is in a position to influence personnel decisions (such as the recruitment, offer of
employment, evaluation of performance, promotion, granting of tenure, or termination of employment) with
respect to another with whom the faculty or staff member has a relationship, which might reasonably be
construed as a conflict or potential conflict of interest, then the faculty or staff member has a duty to disclose the
situation to the administrative head of the unit ..."
Please note that requests for appointments, where the appointee is a relative of the supervisor, that are not
accompanied by a signed Conflict of Interest Form will not be processed.
APPOINTMENT DETAILS
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: _____________________________________________________________________________
RELATIONSHIP DETAILS
Is the incumbent a relative? Yes No
What is your relationship to the incumbent? Spouse Child Sibling Other: __________________
APPOINTEE QUALIFICATIONS
Is the incumbent qualified for the position? Yes No
In the field below, enter a “written declaration” outlining how the incumbent meets the qualifications of the
position and indicating that no conflict of interest exists:
SUPERVISOR DECLARATION
I declare that this appointment does not constitute a conflict of interest.
I declare that all information provided on this conflict of interest form is true and accurate.
Accepted:
_____________________________ _________________________________ ________________________
Printed Name
Signature
Date
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