Personal Information February 2013
In the coming year, there are new statutory requirements being introduced by a number of different organisations which require us to undertake a thorough review of all the personal data we currently hold about you and to ask for some additional information.
All fields on this form are mandatory and must be completed for payroll purposes and to allow the University to complete various anonymous statutory returns and/or to comply with legislative requirements. The information gathered below will inform our equality and diversity activities and be used for monitoring and reporting purposes only and to meet its obligations under the Equality Act 2010 and Disability Equality. All information will be held in the strictest of confidence in accordance with Data Protection legislation.
See Note A for our Fair Processing Statement.
* delete as appropriate
Personal Details
Title: Prof/Dr/Mr/Mrs /Ms /Miss*
Surname/Family Name (please highlight your Family name):
Forenames (in full):
Address:
Telephone Number:
Date Of Birth: DD/MM/YY
Nationality:
Mobile Phone Number:
Email Address:
Legal Sex: Male/Female*
Emergency Contact Info
Full Name:
Address:
Contact Telephone Number:
Relationship to you, (eg partner, friend, parent):
Next of Kin (if different to Emergency Contact)
Full Name:
Address:
Contact Telephone Number:
Relationship to you, (eg partner, friend, parent):

Ethnic Origin: 1 I classify myself as - please tick the most appropriate box below.
White – Scottish
Gypsy or Traveller
Black/Black British – African
Asian/Asian British – Indian
Asian/Asian British – Bangladeshi
Chinese
Mixed - White & Black African
Other mixed background
Other ethnic background
Information refused
Other White background
Black/Black British – Caribbean
Other Black background
Asian/Asian British – Pakistani
Other Asian background
Mixed - White & Black Caribbean
Mixed – White & Asia
Arab
Not known
Do you consider yourself to have a disability? (please tick the relevant boxes below)
00 No known disability
51 A specific learning difficulty such as dyslexia, dyspraxia or AD(H)D
53 A social/communication impairment such as Asperger's syndrome/other autistic spectrum disorder
55 A mental health condition, such as depression, schizophrenia or anxiety disorder
57 Deaf or serious hearing impairment
96 A disability, impairment or medical condition that is not listed
08 Two or more impairments and/or disabling medical conditions
52 General learning disability (such as
Down's syndrome)
54 A long standing illness/health condition such as cancer/HIV/diabetes/chronic heart disease/epilepsy
56 A physical impairment or mobility issues, such as difficulty using arms or using a wheelchair or crutches
58 Blind or a serious visual impairment uncorrected by glasses
97 Information refused
Highest Educational Qualification (please tick the relevant boxes below)
1 Doctorate
2 Other higher degree
22 HND/HNC
29 Other undergraduate qualification
(including professional)
31 A level, Scottish Higher or equivalent
32 O level/GCSE or equivalent
3 PGCE
9 Other Postgraduate qualification
(including professional)
11 First Degree
12 First degree with Qualified Teacher
Status (QTS)
19 Other qualifications at first-degree level (including professional)
21 Diploma of HE
97 Other qualification
98 No qualifications
99 Not known
1 Ethnic Origin classification based on HESA categorisation

Personal Information February 2013
Academic Teaching Qualification (please tick the relevant boxes below)
1 Successfully completed an institutional provision in teaching in the higher education sector accredited against the UK Professional Standards Framework
2 Recognised by the HEA as an Associate Fellow
3 Recognised by the HEA as a Fellow
4 Recognised by the HEA as a Senior Fellow
5 Recognised by the HEA as a Principal Fellow
6 Holder of a National Teaching Fellowship Scheme Individual Award
7 Holder of a PGCE in higher education, secondary education, further education, life long learning or any other equivalent UK qualification
8 Accredited as a teacher of their subject by a professional UK body
9 Other UK accreditation or qualification in teaching in the higher education sector
10 Overseas accreditation or qualification for any level of teaching
90 Not known
99 No qualification held
The information gathered below will inform our equality and diversity activities and be used for monitoring and reporting purposes only. All information will be held in the strictest of confidence in accordance with
Data Protection legislation.
What religion, religious denomination or body to you belong to? (please tick)
No Religion
Christian – Church of Scotland
Christian – Other denomination
Jewish
Sikh
Other religion or Belief
Buddhist
Christian – Roman Catholic
Hindu
Muslim
Spiritual
Prefer not to answer
What is your sexual orientation? FOR UK CAMPUSES ONLY (please tick):
Bisexual
Heterosexual
Gay Man
Other
Gay Woman/Lesbian
Prefer not to answer
What is your marital status? (please tick):
Married
Divorced
Single
Civil Partnered
Separated
Widow / Widower
Co-habiting
Other
Prefer not to answer
Is your gender identity the same as the gender you were assigned at birth? (please tick):
Yes No Prefer not to answer

Note A – Fair Processing Notice: How Heriot-Watt University uses your information
Heriot-Watt University is a public authority with a number of legal duties placed upon us to ensure that we eliminate unlawful discrimination and promote equal opportunities. To help us meet these duties we are collecting information about our service users to help us plan activity for improving our services. Under the
Data Protection Act the information you give us is voluntary and Heriot-Watt University will keep your personal details safe and secure with strict limits on who has access to the information and you may ask us to stop processing this data at any time. By filling in the form and returning it, you are consenting to your data being processed and looked after in this way. If you have any questions or queries about this please contact the Data Protection Officer at FOI@hw.ac.uk
.