Skip to main content Skip to navigation

Warwick Institute of Engagement

WIE Declaration of Personal Interests Form (FP1a)

In accordance with University Financial Procedure 1 ‘Conflicts of Interest’ (FP1) all staff, of all levels, must complete/update this document as soon as they become aware of a potential conflict or anything that could be perceived to be a conflict.

This form must be completed at least annually by every member of staff, full or part-time, of level 6 and above and everyone involved in the purchasing process or in a financial role. Please note 'Nil' returns are required.

Please also read the HR Personal Conflicts of Interest Policy before completing this form.

Personal Information

Section 1

Have you, at any time over the last twelve months, (see *1 below), occupied a position of Director, Non-executive Director, Partner, Consultant, Trustee, Trader or Employee of any external organisation (including Statutory Authorities) or had any other external appointment (e.g. as a Committee member)? (required)
If the appointment is on-going tick here
To the best of your knowledge does the University transact with the above organisation?
Is this position for a Spin Out Company?
Is this position paid?
Attach file
No files are currently attached.

Section 2

Have you, at any time over the last twelve months, held (see *1 below), conducted any other paid work and/or held other significant financial interests (e.g. shareholding), as defined in Section 1.5(a) of FP1? (required)

Section 3

Have you been offered or received any gifts or hospitality during the last twelve months (see note 1 below)? Please note these should be declared to your Head of Department/Centre/Activity immediately and preferably prior to acceptance (as defined in Sections 1.7 and 1.8 of FP1) (required)

Section 4

To the best of your knowledge, have any ‘related parties’, (e.g. family members, friends or other associates) as defined in Section 1.1 of FP1, held positions, appointments or significant financial interests or received gifts or hospitality which could create a conflict of interest? (required)

Section 5

Please read the HR Personal Conflicts of Interest Policy and then indicate below that you have read the policy and taken any necessary action. This policy provides guidance on areas where an interest or relationship may conflict, or appear to conflict, with an individual’s role, duties or responsibilities at Warwick. The policy is to ensure that individuals do not commit acts of impropriety, bias, abuse of authority, favouritism, or leave themselves open to allegations that they have done so. (required)

Section 6

Are there any other conflicts, or potential conflicts, which you need to disclose in order to comply with the Conflicts of Interest Policy (FP1)? (required)
I confirm that I have read and understood the Conflicts of Interest Policy (FP1) and that based on this policy the information given in this form is to the best of my knowledge true and accurate in all respects. (required)
*If you would like to retain a copy of the completed document please press PRINT on the tool bar before selecting the 'SEND FORM' button.*
If ‘YES’ please attach FP10a (see *2 below) at end of Section 1
Notes *1 or period since last FP1a declaration if longer *2 FP10a forms do not need to be completed annually unless requested on the original FP10a approval, but should be attached for information
Privacy notice

Information disclosed is solely for the use of the University and remains confidential within the University unless it is legally required to be disclosed. The information provided will be reviewed by the Head of Department in line with the Declaration of Interests and Private Work procedures.

The University of Warwick is the Data Controller of any information you have entered on this form and is committed to protecting the rights of individuals in line with Data Protection Legislation. The University's Data Protection webpages provide further information on your rights and how the University processes personal data. If you wish to submit a data subjects rights request, make a complaint or report a suspected personal data breach, please contact the University’s Data Protection Officer by email at infocompliance@warwick.ac.uk.

Spam prevention

Failure to load reCAPTCHA

reCAPTCHA is a utility used to verify you're not a robot filling out this form. Unfortunately this has failed to load correctly.

Please try reloading the page. If the problem persists, or if you are in a country which blocks Google products, please contact us by using the ‘page contact’ link at the foot of this page.