Do not write in this Space
INSTRUCTIONS
Please answer each question
clearly and completely, Type or
print in ink. Read carefully and
UNITED NATIONS
follow all directions
PERSONAL HISTORY Please attach a photo
1. Family name First name Other names Maiden name
2. Date Day Mo. Yr. 3. Place of birth 4. Nationality at 5. Present 6. Sex
of birth nationality
birth
7. Height 8. Weight 9. Marital
status:
Single Married Separated Widow(er) Divorce
d
10. Entry into United Nations service might entail assignment and travel to any area of the world in which the United Nations
might have responsibilities. Have you any disabilities which might limit your prospective field of work or your ability to engage
in air travel?
YES NO If "yes", please
describe.
11. Permanent address 12. Present address 13. Office Telephone No.
Telephone No. Telephone No. 14. FAX No. if available
15. Have you any dependants?
YES NO If the answer is "yes", give the
following information:
NAME Age Relationship NAME Age Relationship
16. Have you taken up legal permanent residence status in any country other that of your nationality? YES NO
If answer is "yes", which country?
17. Have you taken up 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 Relationshi Name of international
p organisation
19. What is your preferred field of work?
20. Would you accept employment for 21. Have you previously submitted an application for employment
less then six months? with U.N.? If so, when?
YES NO
22. KNOWLEDGE OF LANGUAGES. What is your mother tongue ?
OTHER LANGUAGES READ WRITE SPEAK UNDERSTAND
Easily Not easily Easily Not Easily Fluentl Not fluently Easily Not Easily
y
23. For clerical grades only
Indicate speed in words per minute List any office machine or equipment you can use
English French Other languages
Typing
Shorthand
24. EDUCATION. Give full details - N.B. Please give exact name of institution and titles of degrees in original language.
Please do not translate or equate to other degrees.
A. University or equivalent:
Years attended
Name, place and country Degrees and academic distinctions Main course of study
from to
B. Schools or other formal training or education from age 14 (e.g., high school, technical school or apprenticeship)
Years attended
Name, place and country Type Certificates or diplomas
fr
obtained
25. List professional societies and activities in civic, public or international affairs
26. List any significant publications you have written (Do not attach)
27. 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.
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:
Number and kind of employees Reason for leaving:
supervised by you:
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:
Number and kind of employees Reason for leaving:
supervised by you:
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:
Number and kind of employees Reason for leaving:
supervised by you:
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:
Number and kind of employees Reason for leaving:
supervised by you:
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:
Number and kind of employees Reason for leaving:
supervised by you:
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:
Number and kind of employees Reason for leaving:
supervised by you:
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:
Number and kind of employees Reason for leaving:
supervised by you:
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:
Number and kind of employees Reason for leaving:
supervised by you:
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:
Number and kind of employees Reason for leaving:
supervised by you:
DESCRIPTION OF YOUR DUTIES:
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 permanent civil servant in your government's employ ? YES NO
If answer is "yes", when ?
30. REFERENCES: List three persons, not related to you, 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. 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 any other document requested by the United Nations renders a staff member of the United Nations liable to
termination or dismissal.
DATE: 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 or references or testimonials unless they have been obtained for the sole use of the Organization.
