QUESTIONNAIRE
Questionnaire for new international staff
Dear Sir/Madam,
You have been asked (in the accompanying e-mail) to fill out this questionnaire . Additionally, with this
questionnaire we ask you to submit some documents.
We need your information for the following processes:
- to prepare your appointment (if you will be appointed to a salaried position), and/or
- to prepare your file if you will become a PhD or a guest researcher (non-salaried in the Netherlands), and/or
- in order to determine the tax and social security status resulting from your appointment or your personal
circumstances, and/or
- in order to prepare your visa application (if you have a non-EU nationality or the Croatian nationality).
In the accompanying e-mail it is mentioned to whom you should send your filled out questionnaire and
documents (see checklist at I). We thank you for your cooperation.
*Mandatory for ICT facilities
A Personal information
1. Given name(s) (in full)
2. Preferred name
3. Surname
4. Degree(s)
5. Gender
6. Date of birth
7. Land of birth
8. Place of birth
9. Nationality
10. Current home address /street
11. Postal code, town, country
12. Mobile phone number*
13. E-mail*
14. Are you going to live (as resident) in the Netherlands?
15. If no: in which country will you have your main residence?
16. If yes: what is your (future) Dutch home address
(if already known)
17. (Future Dutch) Postal code and town
18. BSN number (leave blank if unknown)
19. Dutch IBAN bank account number (leave blank if yet unknown)
fill in name(s)
fill in preferred name
fill in surname
fill in the degrees
choose gender from list
fill in date of birth
fill in land of birth
fill in place of birth
fill in nationality
fill in adres/street
fill in postal code and town
fill in mobile phone number
fill in personal email address
☐ Yes ☐ No
fill in country
fill in address/street
fill in postal code and town
fill in your 9-digit BSN
fill in IBAN bank account number
B Marriage/Registered partnership/partnership
20. Marriage/ Registered partnership/partnership
21. Given name(s) (in full)
22. Surname
23. Date of marriage/partnership
choose registration
fill in name(s)
fill in surname
fill in date
C Emergency contact information
24. First and Surname
25. Current address /street
26. Postal code and town
27. Telefphone number
28. E-mail
fill in names
fill in adres/street
fill in postal code and town
fill in phone number
fill in email adres
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D Registration
29. Can we mention your contact information on the staff pages of
☐ Yes ☐ No
☐ Yes ☐ No
our university website?
30. May we list your office details on our University’s website?
31. Married women are registered under their maiden names. Please indicate how you would like to be
addressed by us:
☐ Maiden name
☐ Maiden name + name partner
☐ Name partner
☐ Name partner + maiden name
Section E should only be filled in by non-EU or Croatian nationals
E Visa Application
Because you have a non-European nationality or the Croatian nationality we need to apply for your residence
permit (which also contains the work permit). In order to enter the Netherlands as an immigrant, in most cases we
need to apply for a long term visa (MVV).
32. At which Dutch Embassy or Dutch Consulate General in your country of residence would
you like to pick up the visa?
fill in embassy or DCG
Information about Dutch embassies can be found on www.mfa.nl/en/
33. Please indicate if you wish the University to apply for visa for spouse and/or children
☐ Yes ☐ No
If you wish to bring your spouse/partner and/or child(ren) to the Netherlands and you want the University to apply for
their visa on your behalf, please contact the International Service Desk: isd@rug.nl
F Additional job
34. Will you be holding another position (paid or unpaid) besides your (future)
work for our University?
35. If yes, are you appointed as a professor or a lecturer?
36. Are you appointed as a government official/civil servant in another country?
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
G Job experience
37. Did you work at the University of Groningen before?
38. Do you have work experience at another public-sector organization?
☐ No
☐ No
☐ Yes ,my P-number is
☐ Yes
To be able to establish, for example, the date of your jubilee, we request that you submit digital copies of documents detailing your
employment record with other public-sector organizations and universities (including military service and student-assistantships)
to HR-Services. You will need to make a print-out of your ABP public-sector employment record overview. This is how it’s done:
At www.abp.nl (‘u bouwt pensioen op’) / go to ‘mijn abp’/ log in with your login details or create these if this your first visit / go to
‘diensttijd overheid’ and make a print-out. If it is the first time you are logging in at mijnabp.nl you will need a personal code. You
will find this code on the ABP pension overview that you receive every year. If any appointment details are missing in the ABP
overview, you will need to submit separate documentary evidence. This can be handed in or sent by e-mail
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Section H should only be completed by PhD students
H Prior university education (highest degree held)
39. Name of institution
40. Address of university
41. Postal code, town, country
42. Faculty
43. Degree programme
44. Date of degree
45. Type of degree
fill in name of institution
Your PhD. Programme at the University of Groningen:
46. Period of study
47. Major subject
48. Native language
49. Project title
50. Supervisors (“first and second/co-promotores”)
51. Faculty or Institute at the University of Groningen
52. Research department at the University of Groningen
I certify that I have read all application instructions and that the information I have provided is true and complete. I
understand that misrepresentation may be a cause for cancellation of my admission or appointment. I understand
that all documents I submit as part of this application become the property of the University of Groningen (and/or
the applicable involved Graduate School of the faculty).
☐ I agree
Signature
Name:
Date:
Signature (if signed by hand: please scan the filled in document)
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I Checklist
Please mail scans (in PDF) of the following documents together with this questionnaire:
☐ Copy of your passport (pages stating personal details and period of validity only)
☐ CV with at least the following information: your current home address, e-mail address, marital status
☐ Copy of Master or PhD diploma: copy of the original AND a translation by an official translator, either in Dutch
or English (if the original is in another language).
☐ For non-EU or Croatian nationals: signed antecedents certificate (see next page)
Only if you will be appointed to a salaried position:
☐ the filled out form “Income Tax”, to be found at :
http://www.rug.nl/about-us/work-with-us/information-for-new-staff
☐ the filled out form “Acknowledgment Additional Activities”, to be found at :
http://www.rug.nl/about-us/work-with-us/information-for-new-staff
Only if you will be a PhD or guest researcher without salary from the University of Groningen:
☐ Proof of sufficient financial means, which can be:

A bank statement showing enough balance1: this bank statement should be stamped and signed by the bank;
it should contain the bank address, your name and your bank account number, or
 (if rewarded) A grant statement from the University of Groningen. This statement should at least state the
monthly amount for living expenses and the period of the grant (from day/month/year until
day/month/year), or
 (if rewarded) A grant statement from any other scholarship provider. This statement should at least state the
monthly amount for living expenses and the period of the grant (from day/month/year until
day/month/year), or
 a combination of two or more of the options listed above
Please note: you will have to bring those original documents with you to Groningen.
For prospective PhDs (both salaried and non-salaried) you also have to bring the following items:
☐ Original Master’s transcript or certified copies
☐ English test scores; this is not applicable if you are a native English speaker or obtained your Master’s degree in
an English-language programme.
The following documents do not need to be sent to the University of Groningen, but must be arranged in advance
as you will need to present them at the City Hall of Groningen upon arrival:
☐ Your original legalized2 birth certificate(s) and a translation by an official translator, either in Dutch or English
Questions? This will help to address your question to the right person/department:

Recruitment and conditions of employment: HR Advisor

Administration of appointment: HR-Services@rug.nl

Welcome & onboarding foreign salaried staff: HR Information Desk (HR-Services@rug.nl)

Visa and residence permit application: International Service Desk (isd@rug.nl)

PhD trajectory: Graduate School of respective Faculty
1 The minimum monthly amount for a researcher
without an accompanying family is EUR 1,136.00 per month. The minimum
monthly amount for a researcher and an accompanying family is EUR 1.622.00 per month.
2 Information about legalization/apostille can be found on the website: http://www.minbuza.nl/en/services/consularservices/legalisation-of-documents/legalisation-of-documents.
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Section J should only be filled in by non-EU or Croatian nationals (visa requirement):
J Antecedents Certificate
Please state the situation that applies to you below. This certificate only needs to be completed if the foreign
national is 12 years of age or older.
If this antecedents certificate has not been completed truthfully, this will have consequences for your right of
residence.
Please tick the boxes:
☐ I certify that:
 I have never been sentenced to imprisonment or a custodial measure for committing a crime;
 I have never been sentenced to perform community service for committing a crime;
 I have never been imposed an unconditional fine for committing a crime;
 I have never accepted an out-of-court settlement for committing a crime;
 I have never been imposed a penalty order by a public prosecutor for committing a crime;
 I am currently not subject to prosecution for committing a crime;
 I have never been responsible for one of the following categories of acts as referred to in Article 1F of the
1951 Refugee Convention: a crime against peace, a war crime, a crime against humanity, a serious nonpolitical crime (for example murder or terrorism), or acts contrary to the purposes and principles of the
United Nations (for example terrorist acts); and
 I am aware of the fact that a sentence for committing a crime may result in a refusal or termination of the
right of residence.
I have not submitted any incorrect data during earlier residence procedures;
 I did not reside in the Netherlands illegally in the past;
 I am not subject to any entry ban.
☐ I am unable to certify the above for the following reasons:
fill in the reasons why you can't certify
Signing:
First name:
Surname:
Date of birth:
Nationality:
Place and date
Signature(if signed by hand: please scan the filled in document)
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