INSTRUCTIONS

Please answer each question clearly and completely. Read carefully and follow all directions.

UNITED NATIONS

PERSONAL HISTORY FORM

Do not write in this space

1. Family name

First name

Fathers name

Maiden name, if any

2. Date of 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 U.N. 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. (a) Passport/Identity Card No. (b) Ration Card No.

12. Permanent address

Telephone no.

13. Present address

Telephone no.

14. Office telephone no.

15. Fax no. if available

16. Have you any dependents? Yes No If the answer is “yes”, give the following information:

Name

Age

Relationship

Name

Age

Relationship

17. 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?

18. Have you taken any legal steps towards changing your present nationality? Yes No

If the answer is “yes”, explain fully.

19. Are any of your relatives employed by a public international organization? Yes No

If the answer is “yes”, give the following information:

Name

Relationship

Name of international organization

20. What is your preferred field of work?

21. Would you accept employment for less than six months?

Yes No

22. Have you previously submitted an application for employment with the U.N.? Yes No

If the answer is “yes”, when?

23. KNOWLEDGE OF LANGUAGES: What is your mother tongue?

Read

Write

Speak

Understand

Other languages

Easily

Not Easily

Easily

Not Easily

Fluently

Not Fluently

Easily

Not Easily

24. For clerical grades only: Indicate speed in words per minute

List any office machines or equipment you can use

Other Languages

English

French

Arabic

Typing

Shorthand

25. Education Give full details

N.B. Please give exact titles of degrees in original language. Please do not translate or equate to other degrees.

(A) University or equivalent

Attended from/to

Degrees and academic

Main course of study

Name, place, country

Month/Year

distinctions obtained

(B) Schools or other formal training or education from age 14 (e.g., high school, technical school or apprenticeship)

Type

Attended from/to

Certificates or

Name, place, country

Month/Year

diplomas obtained

26. List professional societies and activities in civic, public or international affairs

27. List any significant publications you have written (do not attach)

28. EMPLOYMENT RECORD: Start with present post and 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.

A. PRESENT POST (LAST POST, IF NOT PRESENTLY IN EMPLOYMENT)

From

Salaries per annum

Exact title of your post

Month/Year

Starting

Final

Name of employer

Type of business

Address of employer

Name of supervisor

Number and kind of employees supervised by you

Reason for leaving

Descriptions of your duties

B. PREVIOUS POSTS (IN REVERSE ORDER)
From	To	Salaries per annum			Exact title of post
Month/Year	Month/Year	Starting		Final

Name of employer					Type of business
Address of employer					Name of supervisor
					Number and kind of employees supervised by you	Reason for leaving
Descriptions 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 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

29. Have you any objections to our making inquiries with your present employer? Yes No
30. Are you now, or have you ever been, a civil servant in your government’s employ? Yes No
31. 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 28.
Full name	Full address	Business or occupation



32. State any other relevant facts. Include information regarding any residence outside the country of your nationality.














33. 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 (exceeding minor traffic violations)? Yes No If the answer is “yes”, give full particulars of each case in an attached statement.
34. 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
35. 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: 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 reference or testimonials unless they have been obtained for the sole use of the Organization.