$ INSTRUCTIONS Please answer each question clearly and completely. TYPE OR PRINT LEGIBLY.

Read care ully and ollow all directions.

$. (. 2. $9. %amily name !ate o )day*month*yr+ Birth 3ei4ht 5. "ei4ht ,. %irst name !o not "rite in This #pace

UNITED

NATIONS

PERSONAL HISTORY
&iddle name &aiden name' i any

6.

Place o -irth &arital #tatus7 ..

Nationality)ies+ at -irth /.

Present Nationality)ies+ 0. #e1

&arried #eparated

"idow)er+

!i8orced

Entry into :nited Nations ser8ice mi4ht require assi4nment to any area o the world in which the :nited Nations mi4ht ha8e responsi-ilities. )a+ ;re there any limitations on your a-ility to per orm in your prospecti8e ield o wor<= YE# NO )-+ ;re there any limitations on your a-ility to en4a4e in all tra8el= YE# NO Permanent address $(. Present address $,. $..

#in4le

$$.

O ice Telephone No. O ice %a1 No.

Telephone No. ) +
$/. !o you ha8e any dependent children= Name o @hildren YE#

Telephone*%a1 No. ) +
NO

) + ) + E-mail:
Nationality

I the answer is >yes?' 4i8e the ollowin4 in ormation: Place o Birth Gender

!ate o Birth )day*mo*year+

$/. )a+ $0. $2.

Name o #pouse

YE#

NO

3a8e you ta<en up le4al permanent residence status in any country other than that o your nationality= I answer is >yes?' which country= 3a8e you ta<en any le4al steps towards chan4in4 your present nationality= I answer is >yes?' e1plain ully7

YE#

NO NO
Name o International Or4aniAation

$5.

;re any o your relati8es employed -y a pu-lic international or4aniAation= YE# I answer is >yes?' 4i8e the ollowin4 in ormation7 N;&E Relationship

$6. (9. ((.

21.

"hat is your pre erred ield o wor<= "ould you accept employment or less than si1 months= 3a8e you pre8iously su-mitted an application or employment and*or under4one any tests with :.N.= YE# NO I so' when=

YE#

NO RE;!
Easily Not Easily

BNO"LE!GE O% L;NG:;GE#. "hat is your mother ton4ue=

OT3ER L;NG:;GE#
(,. %or clerical 4rades only Indicate speed in words per minute En4lish Typin4 #horthand

"RITE
Easily Not Easily

#PE;B
%luently Not %luently

:N!ER#T;N!
Easily Not Easily

%rench

Other lan4ua4es

List any o ice machines or equipment and computer pro4rammes you use.

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(.. E!:@;TION' Gi8e ull details D N.B. Please 4i8e e1act titles o de4rees in ori4inal lan4ua4e. Please do not translate or equate to other de4rees. ;TTEN!E! %RO&*TO &onth*Year &onth*Year !EGREE# and ;@;!E&I@ !I#TIN@TION# OBT;INE! &;IN @O:R#E O% #T:!Y

;. :ni8ersity or equi8alent N;&E' PL;@E ;N! @O:NTRY Please 4i8e complete address.

B. #@3OOL# OR OT3ER %OR&;L TR;INING OR E!:@;TION %RO& ;GE $. )e.4.' hi4h school' technical school or apprenticeship+
N;&E' PL;@E ;N! @O:NTRY Please 4i8e complete address. TYPE YE;R# ;TTEN!E! %RO& TO @ERTI%I@;TE# OR !IPLO&;# OBT;INE!

(/. LI#T PRO%E##ION;L #O@IETIE# ;N! ;@TIEITIE# IN @IEI@' P:BLI@ OR INTERN;TION;L ;%%;IR#

(0. LI#T ;NY #IGNI%I@;NT P:BLI@;TION# YO: 3;EE "RITTEN (DO NOT ATTACH)

(2.

E&PLOY&ENT RE@OR!7 #tartin4 with your present post' list in REEER#E OR!ER e8ery employment you ha8e had. :se a separate -loc< or each post. Include also ser8ice in the armed orces and note any period durin4 which you were not 4ain ully employed. I you need more space' attach additional pa4es o the same siAe. Gi8e -oth 4ross and net salaries per annum or your last or present post. ;. PRE#ENT PO#T )L;#T PO#T' I% NOT PRE#ENTLY IN E&PLOY&ENT+ %RO& TO #T;RTING #;L;RIE# PER ;NN:& %IN;L TYPE O% B:#INE## N;&E O% #:PEREI#OR NO. ;N! BIN! O% E&PLOYEE# #:PEREI#E! BY YO:7 EF;@T TITLE O% YO:R PO#T7

&ONT3*YE;R &ONT3*YE;R N;&E O% E&PLOYER7 ;!!RE## O% E&PLOYER7

RE;#ON %OR LE;EING

!E#@RIPTION O% YO:R !:TIE#7

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B. PREEIO:# PO#T# )IN REEER#E OR!ER+ %RO& &ONT3*YE;R TO &ONT3*YE;R #;L;RIE# PER ;NN:& #T;RTING %IN;L TYPE O% B:#INE##7 N;&E O% #:PEREI#OR7 NO. ;N! BIN! O% E&PLOYEE# #:PEREI#E! BY YO:7 !E#@RIPTION O% YO:R !:TIE# EF;@T TITLE O% YO:R PO#T7

N;&E O% E&PLOYER7 ;!!RE## O% E&PLOYER7

RE;#ON %OR LE;EING7

%RO& &ONT3*YE;R

TO &ONT3*YE;R

#;L;RIE# PER ;NN:& #T;RTING %IN;L

EF;@T TITLE O% YO:R PO#T7

N;&E O% E&PLOYER7 ;!!RE## O% E&PLOYER7

TYPE O% B:#INE##7 N;&E O% #:PEREI#OR7 NO. ;N! BIN! O% E&PLOYEE# #:PEREI#E! BY YO:7 !E#@RIPTION O% YO:R !:TIE#

RE;#ON %OR LE;EING7

%RO& &ONT3*YE;R

TO &ONT3*YE;R

#;L;RIE# PER ;NN:& #T;RTING %IN;L

EF;@T TITLE O% YO:R PO#T7

N;&E O% E&PLOYER7 ;!!RE## O% E&PLOYER7

TYPE O% B:#INE##7 N;&E O% #:PEREI#OR7

NO. ;N! BIN! O% E&PLOYEE# #:PEREI#E! BY YO:7 !E#@RIPTION O% YO:R !:TIE#

RE;#ON %OR LE;EING7

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(5. 3;EE YO: ;NY OBGE@TION# TO O:R &;BING INH:IRIE# O% YO:R PRE#ENT E&PLOYER=

YE# YE#

NO NO

(6. ;RE YO: NO" OR 3;EE YO: EEER BEEN ; @IEIL #ERE;NT IN YO:R GOEERN&ENTI# E&PLOY= I answer is >yes?' "3EN=

,9.

RE%EREN@E#7 List three persons' not related to you' and are not current :nited Nations sta mem-ers' who are amiliar with your character and quali ications. Do not repeat names of supervisors isted under Item 2!. %:LL N;&E %:LL ;!!RE## B:#INE## OR O@@:P;TION

,$.

#T;TE ;NY OT3ER RELEE;NT %;@T#. IN@L:!E IN%OR&;TION REG;R!ING ;NY RE#I!EN@E O:T#I!E T3E @O:NTRY O% YO:R N;TION;LITY.

,(. 3;EE YO: EEER BEEN ;RRE#TE!' IN!I@TE!' OR #:&&ONE! INTO @O:RT ;# ; !E%EN!;NT IN ; @RI&IN;L PRO@EE!ING' OR @ONEI@TE!' %INE! OR I&PRI#ONE! %OR T3E EIOL;TION O% ;NY L;" )e1cludin4 minor tra ic 8iolations+= YE# NO I >yes?' 4i8e ull particulars o each case in an attached statement.

,,. OT3ER ;GEN@IE# O% T3E :NITE! N;TION# #Y#TE& &;Y BE INTERE#TE! IN O:R ;PPLI@;NT#. !O YO: 3;EE ;NY OBGE@TION TO YO:R PER#ON;L 3I#TORY %OR& BEING &;!E ;E;IL;BLE TO T3E&= YE# NO

I certi y that the statements made -y me in answer to the ore4oin4 questions are true' complete and correct to the -est o my <nowled4e and -elie . I understand that any misrepresentation or material omission made on a Personal 3istory orm or other document requested -y the Or4aniAation renders a sta mem-er o the :nited Nations lia-le to termination or dismissal.
,..

!;TE )day' month' year+

#IGN;T:RE7

N.B. You will -e requested to supply documentary e8idence which supports the statements you ha8e made a-o8e. !o not' howe8er' send any documentary e8idence until you ha8e -een as<ed to do so -y the Or4aniAation and' in any e8ent' do not su-mit the ori4inal te1ts o re erences or testimonials unless they ha8e -een o-tained or the sole use o the Or4aniAation.

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