UNITED NATIONS NATIONS UNIES

HR MINI MASTER REGISTRATION FORM

NOTE: This form is to be used by non-staff individuals including meeting participants and staff administered by
other agencies.

Instructions:
1. Please answer each field completely. Note BOLD fields are Mandatory. TYPE or PRINT in dark ink.
2. Please attach one of the following official supporting documents: copy of passport, copy of birth certificate,
copy of state ID.

Part A – General Data

Title (Mr./Mrs./etc): SRA (MRS)
First Name (as in Government ID): GLEIDY
Middle Name (as in Government ID): YULISSA
Last Name (as in Government ID): MOSQUERA CETRE
If yes, please
Have you worked with the UN in Yes
provide Index
the past? No X
Number
Date of Birth (dd/mm/yyyy): 15/04/1984
(City):
Place of Birth (Country): ISTMINA
CHOCÓ
Gender: Male Female X
Nationality: COLOMBIANA
Email Address: yulismoce@hotmail.com
Telephone Number: 3122007313
Address: Crr 7 # 12 - 76
Colombia Quibdó Chocó 270001 Colombia
(City) Quibdó (Zip Code) 270001 (Country) Colombia
ID Number: (Passport or other) No aplica
ID Date of Issue (mm/dd/yyyy): N/A ID Valid to date
ID Place of Issue:
ID Country of Issue:

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Part B – Banking Data

Account Title: Cuenta de ahorros (Refer #1)
Currency of payment: Pesos colombianos (Refer #2)
Name of Bank: Bancolombia
Address of Bank: Crr 46 # 47 -92 C..C Punto de la oriental, Medellín
Colombia

(City) Medellin (Zip Code) 05001 (Country)

Antioquia
Bank ID number: (Refer #3)
Account # or IBAN: 35158390505
Currency of Account:
Type of Account: Checking OR Savings X (Refer #4)
Routing Instructions (Refer #5)

Part C – Certification by Non Staff/External Individual

Full Name:
By checking this box I certify that the above
Date (mm/dd/yyyy):
information is accurate:

Part D – To be filled by HR Mini Master Administrator

Personnel Subarea (Duty Station) of
Bogotá – CO00
engagement/meeting:
Personnel Area (Country) of
Colombia - CO
engagement/meeting:
Effective date (dd/mm/yyy):
Name & Signature
(HR Mini Master Administrator)
Date (mm/dd/yyyy):

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