Application for incentivised early retirement or voluntary separation

Part A: To be completed and submitted by staff member on or before 30 June 2016

I apply for the:

Incentivised early retirement packagethat has been made available within the University until 30 June 2016.
Voluntary separation packagethat has been made available within the University until 30 June 2016.

Staff member motivation or statement of reasons why application should be approved (optional)

I understand the terms of the package and the conditions applicable to it.

I accept, further, that -

  • the final decision to approve my applicationwill be made by the Executive on recommendation of the unit head(Dean, Executive Director, or Director in a PASS Department where there is no Executive Director) and with the approval of the Remuneration Committee;
  • therecommendation of the unit head is expected to be given by the first week of August 2016, and a final decision is expected to be made during mid-August 2016;
  • if my application is accepted my notice period will by agreement run until 31 December 2016;
  • Iwill make myself available to work during the notice period as required;
  • my employment at the University will terminate with effect from 31 December 2016, on the terms set out in the selectionabove.

Name
Staff number
Faculty or Department
Signature / Date

Part B: To be completed by Dean / ED / Director on or before 5 August 2016

This application for staff member (name) / is
Supported
Not supported

If not supported, brief reasons to be provided below. If requested, this information will be provided to the staff member concerned.

For example: The application is not supported because the departure of the staff member concerned on the terms contained in the package would not support the savings target/ operational needs of the faculty.

Name of Dean / ED / Director(in PASS dept. where no ED)
Faculty or Department
Signature / Date

UCT Human ResourcesPage 1