This is a detailed form to ensure the correct contract is issued

FORM 4 - APPOINTING A MEMBER OF STAFF

Please identify relevant Directorate

Strategy & Business Administration

C&YP Services

Health & Adult Social Services

Customer & Community Services

Policy & Partnerships

Environment, Growth & Commissioning

Finance & Commercial Management

Please note that:

This form should be used for all new starters to NCC, internal transfers and secondments. If completing for an existing employee it is only necessary to complete the mandatory fields indicated* otherwise all fields should be completed.
The post that you are appointing to must be part of your agreed funded establishment or you must have previously obtained authorisation by submitting Form 1 - Establishing a New Post
This form will be returned unless all mandatory sections/fields have been completed and the relevant documentation attached. This may result in a delay in a written offer of employment and/or payment of salary being made.

EMPLOYEE DETAILS
Full Legal name*			NI number*
Address (new employees only)
Postcode			Date of Birth
EXISTING EMPLOYEES ONLY* (please complete all details)
Is this the only assignment held?	Yes	No (Give details)	Other ERP Post no/s.
Previous employment end date	To ensure continuous service applied please give finishing day as Sunday of final week
Reason for leaving previous post	Secondment within NCC Internal recruitment Completion of Temporary Register assignment Other (please specify)

APPOINTMENT DETAILS
ERP Post number*
Start date*				End date* (If fixed term/acting up, maternity cover or secondment)
Secondment into NCC		Yes No
Conditions of service type*	Chief Officer		Teacher		Local Government		FEMS
		Soulbury		Casual Worker		Youth & Community Worker

Contract Type*		Permanent Fixed Term Secondment* Acting Up Casual For fixed term/secondment/acting up, please specify reason: (eg. Replacing [named person] for maternity cover)*
Redeployee*		Yes No
HOURS OF WORK
Hours of work* *Please tick all that apply*	Full time		Part time	Flexible hours
		Job share		Term time	Zero hours
		Compressed hours		Annualised hours
		Home Carer Guaranteed Week
		Hours per week
		Weeks per year	Full year (52.143 weeks per year) Other* *Please state no. of weeks worked per year __________
*Hours of work - specifications**	SCP 28 or below Public holiday working 7 day rota system (7am to 10pm) Weekend working Sleep-in Sleep-in bleep Standby Overtime required Overtime requested Night worker - (10pm - 8am) Social Workers - Night Care Supervisor Evening worker Please insert any other requirements:

PLACE OF WORK
Place of work*		Fixed place			Residential		Home based
				Various places			Specify geographical area if working across a part of the County:
				Full postal address of place of work - Office base: Home base:
Line Manager Name*

SALARY DETAILS
Recruiting Managers who wish to appoint a candidate at a level above the grade minimum should complete the Offering Appointment above the minimum Spinal Column Point form (form 11). Please attach a copy of this form.
Cost Code:* (Cost codes can be found on the ERPnet link on the intranet)	Cost Centre - 7 digits		Subjective			Sub Analysis - 5 digits
				A0001
Appointment starting salary*	Starting spinal point _______ Bar point _______ (if applicable)
Pay point (Destination for pay slip eg A3044)
Salary options*	Please tick if any of the following apply Career progression (Social Workers) Career progression (others) Career progression (Principal Social Workers) Additional payment for training / qualifications (Youth & Community) Skills shortage (IS / IT - Please specify payment £ _______ Incremental progression linked to qualifications Yes/No Market supplement - Please specify amount £______ *If a market supplement is being applied,* *the* *authorisation form should be* *attache*d (form 6).
Allowances*	Please detail any other requirements or allowances: e.g. allowances for emergency call out, stand by, sleeping in, enhancement for Saturday working etc.
Deductions	Rent (State monthly amount) £______________________

OTHER TERMS AND CONDITIONS
Car user status*	Please tick all that apply: (Please attach copy of driving licence) Essential user Casual user Lease car (PO12 and above) Drives Council vehicle Not applicable PLEASE ENSURE A TRAVEL INPUT FORM IS INCLUDED AS PAYMENT WILL NOT BE MADE WITHOUT IT*
Other conditions*	Telephone allowance Regular home working Relocation National Care Standards Commission registered manager Fostering and adoption (3 yearly CRB check applicable) Day centre staff - requirement to take fixed holidays Social Worker Registration Number: _________________ Expiry Date: __________________
Additional documents
Additional documents
The following must be attached to this form:		Checked?	Checked By: (print name)
Proof of identity*		Yes No
Proof of entitlement to work*		Yes No
Completed Application Form*
Where appropriate, the following should also be attached: Declaration of Conflict of Interest form Disclosure of Criminal Convictions Certified copy of qualifications Interview expenses form References (where Service Area has obtained these as part of recruitment decision)
OFFER OF APPOINTMENT SUBJECT TO: Medical Check (Internal applicants will require a further medical check if new or additional role duties are different) CRB clearance Applicants will not be able to commence in a post until all necessary checks have been satisfactorily completed.

Recruiting Manager

Print:

Sign:

Date:

Please post this form to your allocated HR Assistant together with the required documentation specified in the form

April 09