CONTRIBUTION PAY BOARD (CPB)FORM

Application/Recommendation for: Accelerated Increment (AI), Contribution Point (CP) or Bonus Payment (BP)

To be completed by Head of School/Director of Professional Services, or in the case of personal applications, by the member of staff.

Return by email to: / / Not later than: 27th April 2018
Name of Nominee: / Review Period: 2017 PDR YEAR
i.e. 1 January 2017– 31 December 2017
Job Title / Employee Number:
School / Prof Service
Line Manager / PDR Rating for 2017
Application made by
(mark with an X) / Head of School/ Director Professional Service* / Personal Case
*Where application is made by Head of School/Director of Professional Service, please confirm with an "X" ifyour staff member is aware of the submission.
Current Salary as of April 2018 / Current Grade as of April 2018 / Spine Point as of April 2018
Type of reward requested (mark with an X)
Accelerated Increment / Contribution Point / Bonus
(Amount Requested > £501- £1,000)
Has the staff member received any local contribution rewards during the past 12 months? If yes, please give details.

TO BE COMPLETED BY HEAD OF SCHOOL/DIRECTOR OR INDIVIDUAL FOR PERSONAL CASES

Evidence of criteria in support of this application/recommendation. (Refer to criteria and guidance provided in the Contribution Pay Procedure. Outline clearly why the award should be made.)

To be completed by member of staff

Heriot-Watt is committed to equality of opportunity for all. Please highlight circumstances, e.g. career break(s), maternity/paternity/adoption leave, illness, caring responsibilities etc. where work outputs may have been impacted, to allow for consideration in relation to metrics. Please also mention any instances of part-time working including duration and FTE (where full time equals 1.0 FTE). Please provide this information in the Special Circumstances Document. / Delete as Appropriate
Y/N

For Completion by Vice Principal Dubai if appropriate

RecommendationVice Principal:
I confirm that I support the above case and the staff member is aware of this submission. I note that the Board can exceptionally award an alternative contribution award (an increment or bonus) if the Board believes the evidence of the performance merits this.
Signed: Date:
Print Name:
For recommendation by a Head of School or Director of Professional Service:
I confirm that I support the above case and can fund any increased costs within my agreed budget.
Signed: Date:
Print Name:
For recommendation by Secretary of the University (Professional Service Cases only)
I confirm that I support the above case
Signed: Date:
Print Name: Ann Marie Dalton-Pillay
For a Personal Case only: (without support of Head of School or Director of Professional Services):
My Head of School or Director of Professional Servicesis aware of my Personal Case but is unable to support my application.
Signed: Date:
Print Name:

Contribution Pay Board (CPB) Form 2018