ࡱ> _a^b bjbjJJ 4V(Ib(Ib  jjjjj~~~~L~;-Xiii,,,,,,,$/I2,jiiiii,jj,i jj,i,*h+ z'ys+, -0;-+2D2 ++2j,iiiiiii,,iii;-iiii2iiiiiiiii B 0: University College London Consultant Clinical Academic (CCA) and Senior Academic G.P. (SAGP) Contract Seniority Verification Form Please complete this form if: Following a recruitment campaign your successful candidate: Has worked at Consultant level or equivalent in previous years and they will be claiming seniority for this experience when they take up employment at ϲ. Is claiming a period of flexible training (prior to obtaining CCT). You wish to transfer an existing member of ϲ clinical staff on to the terms of the CCA or SAGP contract NAME of Consultant Clinical Academic: GMC/GDC Number:Employee Number if known: (existing ϲ Staff only)Division/Institute and Research Department: Post Title: Specialty:Honorary Contract(s) Held/to be Held with: Date of Entry to the Specialist Register: (this can be found on the GMC/GDC page)Date of First Substantive Consultant level post (UK or Overseas):New Staff already on the new CCA/SAGP Contract Date of Transfer to New Contract:Seniority as at transfer date*: Distinction Award currently held CEA currently held: On Call Currently held:Level: Value Level: Value Category: A/B Frequency:Where this will be first appointment to the Contract Proposed Date of Transfer to the New Contract:Proposed Starting Threshold: *Basic salary on commencement will only be set higher than Threshold 1 subject to a successful claim supported by written evidence to reflect consultant level experience and/or flexible training.Are you claiming any additional Years Seniority? Yes /No (delete as appropriate)If Yes, how many full years are you claiming for? Please itemise here how and where the additional years have been accrued e.g. locum consultant work (including dates:), extended training etc.Trust Name Reason DatesNo. years months  Signature of Local HR Manager DatedSignature of HRBPDated Please attach a copy of the most recent payslip and an up to date CV showing Consultant level salary. If applying for additional Years Seniority, confirmation from the Trust where the employee worked in order to confirm consultant level experience should be obtained. Local HR Managers should forward this document with any additional information in support of this claim to HRBP -Clinical. 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Segoe UI?5 .Cx Courier New;WingdingsA$BCambria Math"hfzzyg!24   3qHP ?*O2! xx University College LondonVanessa Havercroft Liz Jackson      Oh+'0 ,8 X d p |University College LondonVanessa Havercroft Normal.dotm Liz Jackson5Microsoft Office Word@F#@Z%s@dy@Ny ՜.+,0 hp  University College London  University College London Title  !"#$%&'()*+-./012356789:;<=>?@ABCDEFGHIJKLMOPQRSTUWXYZ[\]`Root Entry F'ybData ,1Table42WordDocument4VSummaryInformation(NDocumentSummaryInformation8VCompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q