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UNITED PERSONAL HISTORY

NATIONS

!. "amily name $. Date of %irth +. ,ei-ht .. ei-ht

"irst name &. Place of %irth

Other names '. Nationality at %irth

#aiden name (. Present nationality ). Se*

/. #arital status Sin-le 0 1 #arried 0 1 Separated 0 1 idow2er3 0 1 Di4orced 0 1 !5. 6ntry into United Nations ser4ice mi-ht entail assi-nment and tra4el to any area of the world in which the United Nations mi-ht ha4e responsi%ilities. ,a4e you any disa%ilities which mi-ht limit your prospecti4e field of wor7 or you a%ility to en-a-e in air tra4el8 96S 0 1 NO 0 1 If :yes:; please descri%e. !!. Permanent address !$. Present address !&. Permanent telephone no !'. Present telephone no !(. ,a4e you any dependants8 N=#6 96S 0 =-e 1 NO 0 1 Relationship If the answer is :yes:; -i4e the followin- information< N=#6 =-e Relationship

!). ,a4e you ta7en up le-al permanent residence in any country other than that of your nationality 8 96S 0 1 NO 0 1 If answer is :yes:; which country 8 !+. ,a4e you ta7en any le-al steps towards chan-in- your nationality 8 96S 0 1 NO 0 x 1 If answer is :yes:; e*plain fully < !.. =re any of your relati4es employed %y a pu%lic international or-ani>ation 8 96S 0 1 NO 0* 1 If answer is :yes:; -i4e the followin- information 8 N=#6 Relationship Name of international or-ani>ation

!/. hat is your preferred field of wor7 8 Research on economic and social issues; monitorin- and e4aluation; planiin-; statistics and data analysis; social and human de4elopment; human ri-hts. $5. ould you accept employment for less $!. ,a4e you pre4iously su%mitted an application for employment with U.N. than si* months 8 96S 0 1 NO 0 1 8 If so; when 8 $$. ?NO @6DA6 O" @=NAU=A6S. hat is your mother ton-ue 8 Spanish R6=D RIT6 SP6=? UND6RST=ND OT,6R 6asily Not easily 6asily Not easily "luently Not 6asily Not @=NAU=A6S fluently easily

$&. "or clerical -rades only Indicate speed in words per minute Other lan-ua-es
6n-lish "rench

List any office machines or equipment you can use

Typing Shorthand

24. EDUCATION.

i!" #$%% d"tai%& ' N.B. Please give exact name of institution and titles of degrees in original language. Please do not translate or equate to other degrees . A. Uni!"r&ity or "($i!a%"nt Y"ar& att"nd"d Na)" * p%a+" and +o$ntry #ro) to D"gr""& and a+ad")i+ ,ain +o$r&" o# &t$dy di&tin+tion&

B. Schools or other formal trainin- or education from a-e !' 2e.-. hi-h school; technical school or apprenticeship3
Name; place and country Type 9ears attended from To

Certificates or diplomas o%tained

2-. Li&t pro#"&&iona% &o+i"ti"& and a+ti!iti"& in +i!i+* p$.%i+ or int"rnationa% a##air&

$). @ist any si-nificant pu%lications you ha4e written (Do not attach)

$+. 6#P@O9#6NT R6CORD< Startin- with your present post; list in reverse order e4ery employment you ha4e had. Use a separate %loc7 for each post. Include also ser4ice in the armed forces and note any period durin- which you were not -ainfully employed. If you need more space; attach additional pa-es of the same si>e. /ro) #onthC9ear To #onthC9ear Sa%ari"& p"r ann$) Startin"inal Exa+t tit%" o# yo$r po&t 0 ,onitoring and E!a%$ation O##i+"r

Na)" o# ")p%oy"r 0 =ddress of employer<

Type of %usiness< Name of super4isor Num%er and 7ind of employees super4ised %y you < D6SCRIPTION O" 9OUR DUTI6S

Reason for lea4in-< .

D D
D D D D

/ro) #onthC9ear

To #onthC9ear

Sa%ari"& p"r ann$) Startin"inal

Exa+t tit%" o# yo$r po&t 0 Con&$%tant Part time consultant

Na)" o# ")p%oy"r 0 =ddress of employer<

Type of %usiness< Name of super4isor < Num%er and 7ind of employees super4ised %y you < D6SCRIPTION O" 9OUR DUTI6S

Reason for lea4in-<

D D /ro) #onthC9ear To #onthC9ear Sa%ari"& p"r ann$) Startin"inal Exa+t tit%" o# yo$r po&t 0

Na)" o# ")p%oy"r 0 =ddress of employer<

Type of %usiness< Name of super4isor < Num%er and 7ind of employees super4ised %y you < D6SCRIPTION O" 9OUR DUTI6S

Reason for lea4in-<

D /ro) #onthC9ear To #onthC9ear Sa%ari"& p"r ann$) Startin"inal Exa+t tit%" o# yo$r po&t 0 Con&$%tant Part time consultant

Na)" o# ")p%oy"r 0 =ddress of employer<

Type of %usiness< Name of super4isor < Num%er and 7ind of employees super4ised %y you < D6SCRIPTION O" 9OUR DUTI6S

Reason for lea4in-<

D D /ro) #onthC9ear To #onthC9ear Sa%ari"& p"r ann$) Startin"inal Exa+t tit%" o# yo$r po&t 0

Na)" o# ")p%oy"r 0 =ddress of employer<

Type of %usiness< Name of super4isor < Num%er and 7ind of employees super4ised %y you < D6SCRIPTION O" 9OUR DUTI6S Sa%ari"& p"r ann$) Startin"inal

Reason for lea4in-<

D /ro) #onthC9ear To #onthC9ear Exa+t tit%" o# yo$r po&t 0 Con&$%tant Part time consultant

Na)" o# ")p%oy"r 0 =ddress of employer<

Type of %usiness< Name of super4isor < Num%er and 7ind of employees super4ised %y you < D6SCRIPTION O" 9OUR DUTI6S

Reason for lea4in-<

D D /ro) #onthC9ear To #onthC9ear Sa%ari"& p"r ann$) Startin"inal Exa+t tit%" o# yo$r po&t 0

Na)" o# ")p%oy"r 0 =ddress of employer<

Type of %usiness< Name of super4isor < Num%er and 7ind of employees super4ised %y you < D6SCRIPTION O" 9OUR DUTI6S

Reason for lea4in-<

D $.. ,a4e you any o%Eections to our ma7in- inquiries of you present employer 8 96S 0 1 NO 0 1

$/. =re you now; or ha4e you e4er %een; a permanent ci4il ser4ant in your -o4ernmentFs employ 8 96S 0 1 NO 0 1 If answer is :yes:; when 8 &5. R6"6R6NC6S < @ist three persons; not related to you; who are familiar with your character and qualifications. Do not repeat names of supervisor listed under item 27 "U@@ N=#6 "U@@ =DDR6SS BUSIN6SS OR OCCUP=TION

&!. State any rele4ant facts. Include information re-ardin- any residence outside the country of your nationality.

&$. ,a4e you e4er %een arrested; indicted; or summoned into court as a defendant in a criminal proceedin-; or con4icted fined or imprisoned for the 4iolation of any law 2e*cludin- minor traffic 4iolations3 8 96S 0 1 NO 0 1 If :yes:; -i4e full particulars of each case in an attached statement. &&. I certify that the statements made %y me in answer to the fore-oin- questions are true; complete and correct to the %est of my 7nowled-e and %elief. I understand that any misrepresentation or material omission made on a Personal ,istory form or other document requested %y the United Nations renders a staff mem%er of the United Nations lia%le to termination or dismissal. SIAN=TUR6 < D=T6< N.B. 9ou will %e requested to supply documentary e4idence which supports the statements you ha4e made a%o4e. Do not; howe4er; send any documentary e4idence until you ha4e %een as7ed to do %y the Or-ani>ation and; in any e4ent; do not su%mit the ori-inal te*ts of references or testimonials unless they ha4e %een o%tained for the sole use of the Or-ani>ation.