1. Family name, First name, Middle name, Maiden name, if any

2. Date of birth (Day-Month-Year)

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. 10(a) Are there any limitations on your ability to perform in your prospective field of work? Yes, No. 10(b) Are there any limitations on your ability to engage in all travel? Yes, No.

11. Permanent address, Telephone No.

12. Present address, Telephone No.

13. Office Telephone No.

14. Fax No. if available

E-mail address

15. Have you any dependents? Yes, No. If the answer is "yes", give the following information of all your dependents: Name, Date of Birth, Relationship.

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

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 with U.N.? If so, when?

22. Knowledge of languages. What is your main language? List all other languages with following rating: Read, Easily, Not Easily; Write Easily, Not Easily; Speak, Fluently, Not Fluently; Understand, Easily, Not Easily.

23. Indicate typing speed in words per minute by languages. List software you are proficient with.

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. 24(a) University or equivalent: Name, Place and Country, Attended from (Month-Year) to (Month-Year), Degrees and academic distinctions obtained, Main subject of study. 24(b) Schools or other formal training or education from age 14 (e.g. high school, technical school or apprenticeship). Name, Place and Country, type, Attended from (Year), to (Year), Certificates or diplomas obtained.

25. List all 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, describe in reverse order every employment you have had. Use a separate description for each post. Include also service in the armed forces and note any period during which you were not gainfully employed. Give net salaries per annum for your last or present post. Details includes: From (Month-Year), To (Month-Year), Starting salary per annum, Final salary per annum, Exact title of your post, Name of employer, Type of business, Address of employer, Name of supervisor, Number and kind of employees supervised by you, Reason for leaving, Description of your duties.

28. Have you any objections to our making inquires 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, who are familiar with your character and qualification. Do not repeat names of supervisors listed under Item 27. Details includes 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 under item 31.

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. Signature, Date.

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.

35. Your preferred examination location according to the information provided from our website.