INSTRUCTIONS
Please answer each question clearly and
completely. TYPE OR PRINT LEGIBLY.
Read carefully and follow all directions.
UNITED
NATIONS
PERSONAL HISTORY
Do not Write in This Space
1.
Family name
First name
Middle name
Maiden name, if any
2.
Date of (day/month/yr)
Birth
3.
Place of birth
4.
Nationality(ies) at birth
5.
Present Nationality(ies)
6.
Sex
7.
Height
8.
Weight
9. Marital Status:
Single Married Separated Widow(er) Divorced
10.
Entry into United Nations service might require assignment to any area of the world in which the United Nations might have responsibilities.
(a) Are there any limitations on your ability to perform in your prospective field of work? YES NO
(b) Are there any limitations on your ability to engage in all travel?
YES NO
11.
Permanent address
Telephone No. ( )
12.
Present address
Telephone/Fax No. ( )
13. Office Telephone No.
( )
14. Office Fax No.
( )
E-mail:
15. Do you have any dependent children? YES NO If the answer is “yes”, give the following information:
Name of Children
Date of Birth (day/mo/year)
Place of Birth
Nationality
Gender
15. (a)
Name of Spouse
16. Have you taken up legal permanent residence status in any country other than that of your nationality? YES NO
If answer is “yes”, which country?
17. Have you taken any legal steps towards changing your present nationality?
YES NO
If answer is “yes”, explain fully:
18. Are any of your relatives employed by a public international organization?
YES NO
If answer is “yes”, give the following information:
NAME
Relationship
Name of International Organization
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19. What is your preferred field of work?
20. Would you accept employment for less than six months?
YES NO
21. Have you previously submitted an application for employment and/or undergone any tests
with U.N.?
YES NO If so, when?
22. KNOWLEDGE OF LANGUAGES. What is your mother tongue?
OTHER LANGUAGES
READ
WRITE
SPEAK
UNDERSTAND
Easily
Not Easily
Easily
Not Easily
Fluently
Not Fluently
Easily
Not Easily
23. For clerical grades only
Indicate speed in words per minute
List any office machines or equipment and
computer programmes you use.
English
French
Other languages
Typing
Shorthand
24. EDUCATION, Give full details – N.B. Please give exact titles of degrees in original language. Please do not translate or equate to other degrees.
25.
26. A. University or equivalent
NAME, PLACE AND COUNTRY
Please give complete address.
ATTENDED FROM/TO
DEGREES and ACADEMIC
DISTINCTIONS OBTAINED
MAIN COURSE OF STUDY
Month/Year
Month/Year
NAME, PLACE
AND COUNTRY
Please give
complete address.
TYPE
CERTIFICATES OR DIPLOMAS
OBTAINED
27. LIST PROFESSIONAL SOCIETIES AND ACTIVITIES IN CIVIC, PUBLIC OR INTERNATIONAL AFFAIRS
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NO. AND KIND OF EMPLOYEES SUPERVISED BY YOU:
REASON FOR LEAVINGNAME OF SUPERVISORADDRESS OF
EMPLOYER:TYPE OF BUSINESSNAME OF
EMPLOYER:FINALSTARTINGMONTH/YEARMONTH/YEAREXACT
TITLE OF YOUR POST:EMPLOYMENT RECORD: Starting with your
present post, list in REVERSE ORDER every employment you have had.
Use a separate block for each post. Include also service in the armed forces
and note any period during which you were not gainfully employed. If you
need more space, attach additional pages of the same size. Give both gross
and net salaries per annum for your last or present post.26. LIST ANY
SIGNIFICANT PUBLICATIONS YOU HAVE WRITTEN (DO NOT
ATTACH)
A. PRESENT POST (LAST POST, IF NOT PRESENTLY IN
EMPLOYMENT)
FROM
DESCRIPTION OF YOUR DUTIES: TOSALARIES PER ANNUM
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B. PREVIOUS POSTS (IN REVERSE ORDER)
FROM
TO
SALARIES PER ANNUM
EXACT TITLE OF YOUR POST:
MONTH/YEAR
MONTH/YEAR
STARTING
FINAL
NAME OF SUPERVISOR:NAME OF EMPLOYER:
TYPE OF BUSINESS:
NO. AND KIND OF EMPLOYEES
SUPERVISED BY YOU:
REASON FOR LEAVING:
DESCRIPTION OF YOUR DUTIES
FROM
TO
SALARIES PER ANNUM
EXACT TITLE OF YOUR POST:
MONTH/YEAR
MONTH/YEAR
STARTING
FINAL
NAME OF EMPLOYER:
TYPE OF BUSINESS:
ADDRESS OF EMPLOYER:
NAME OF SUPERVISOR:
NO. AND KIND OF EMPLOYEES
SUPERVISED BY YOU:
REASON FOR LEAVING:
DESCRIPTION OF YOUR DUTIES
FROM
TO
SALARIES PER ANNUM
EXACT TITLE OF YOUR POST:
MONTH/YEAR
MONTH/YEAR
STARTING
FINAL
NAME OF SUPERVISOR:NAME OF EMPLOYER:
TYPE OF BUSINESS:
NO. AND KIND OF EMPLOYEES
SUPERVISED BY YOU:
REASON FOR LEAVING:
DESCRIPTION OF YOUR DUTIES
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28. HAVE YOU ANY OBJECTIONS TO OUR MAKING INQUIRIES OF YOUR PRESENT EMPLOYER?
YES NO
29. ARE YOU NOW OR HAVE YOU EVER BEEN A CIVIL SERVANT IN YOUR GOVERNMENT’S EMPLOY?
YES NO
If answer is “yes”, WHEN?
30. REFERENCES: List three persons, not related to you, and are not current United Nations staff members, who are familiar with your character and qualifications.
Do not repeat names of supervisors listed under Item 27.
FULL NAME
FULL ADDRESS
BUSINESS OR OCCUPATION
31. STATE ANY OTHER RELEVANT FACTS. INCLUDE INFORMATION REGARDING ANY RESIDENCE OUTSIDE THE COUNTRY OF
YOUR NATIONALITY.
32. HAVE YOU EVER BEEN ARRESTED, INDICTED, OR SUMMONED INTO COURT AS A DEFENDANT IN A CRIMINAL PROCEEDING, OR
CONVICTED, FINED OR IMPRISONED FOR THE VIOLATION OF ANY LAW (excluding minor traffic violations)?
YES NO
If “yes”, give full particulars of each case in an attached statement.
33. OTHER AGENCIES OF THE UNITED NATIONS SYSTEM MAY BE INTERESTED IN OUR APPLICANTS. DO YOU HAVE ANY OBJECTION TO
YOUR PERSONAL HISTORY FORM BEING MADE AVAILABLE TO THEM?
YES NO
34.
I certify that the statements made by me in answer to the foregoing questions are true, complete and correct to the best of my
knowledge and belief. I understand that any misrepresentation or material omission made on a Personal History form or other
document requested by the Organization renders a staff member of the United Nations liable to termination or dismissal.
DATE
(day, month, year)
SIGNATURE:
N.B. You will be requested to supply documentary evidence which supports the statements you have made above. Do not, however,
send any documentary evidence until you have been asked to do so by the Organization and, in any event, do not submit the original
texts of references or testimonials unless they have been obtained for the sole use of the Organization.
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