Nepotism Evaluation Form

The University of North Texas Health Science Center and its employees are committed to appointing and promoting university faculty, staff and student employees based on job-related qualifications. The purpose of this form is to evaluate disclosure of all appearances of nepotism so that it can be managed according to university policy.

Nepotism: State law prohibits the employment of persons related within the second degree by affinity (marriage) or within the third degree of consanguinity (blood) to any officer or member of any board making, voting for, or confirming the employment. Whenever an appointment is made, either on a full-time or a part-time basis, it shall be made solely with regard to the qualifications of the appointee, subject to Tex. Govt. Code 573.041. and subject to the provisions of this policy. Employee Ethics and Standards of Conduct (1.102)

Second Degree by Affinity: Two people are related by affinity if they are married to each other, or if one person’s spouse is related by consanguinity to the other person. This applies to the first and second degree.

Third Degree of Consanguinity: Two people are related to each other by consanguinity if one is a descendent of the other or if they share a common ancestor.

Please check the appropriate box(es):(Required)

New Hire

Current Employee

Other

Other(Required)

Your Name(Required)

Name of Your Relative(Required)

Your Job Title(Required)

Relative's Job Title(Required)

Supervisor/Manager(Required)

Division/Department(Required)

Your Email(Required)

Relationship(Required)

1. Will this employment action result in a subordinate-supervisor relationship?(Required)

2. Will the employee work in the same department/division?(Required)

3. Will either employee have direct or indirect authority over the other that affect the terms and condition of employment (e.g. assignments, evaluation, promotion, leave, or disciplinary actions) as set forth in the Institute Policies?(Required)

1A. Provide a detailed explanation as to why your family member, friend or associate was chosen for this role.(Required)

2A. Please describe the vetting process. Were there other candidates? If so, what was the method of their evaluation? Please attach all relevant documentation.(Required)

3A. Elaborate upon the individual’s unique expertise that makes them the sole candidate for this position.(Required)

4A. Are there funding constraints that have impacted your intent to hire? If so, please describe the circumstances.(Required)

Employee Name (Print Name)(Required)

Signature(Required)

Date(Required)

This page was last modified on April 13, 2023