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INSTRUCTIONS

Please answer each question clearly andcompletely. TYPE OR PRINT LEGIBLY.Read care ully and ollow all directions.

UNITED

NATIONS

PERSONAL HISTORY

!o not "rite in This #pace

$. %amily name %irst name

&iddle name

&aiden name' i any

(. !ate o )day*month*yr+Birth ,. Place o -irth . Nationality)ies+ at -irth /. Present Nationality)ies+ 0. #e1 2. 3ei4ht

5. "ei4ht

6. &arital #tatus7#in4le &arried #eparated "idow)er+ !i8orced

$9. Entry into :nited Nations ser8ice mi4ht require assi4nment to any area o the world in which the :nited Nations mi4ht ha8e responsi-ilities. )a+ ;re there any limitations on your a-ility to per orm in your prospecti8e ield o woryes?' 4i8e the ollowin4 in ormation :

Name o @hildren !ate o Birth )day*mo*year+ Place o Birth Nationality Gender

$/. )a+ Name o #pouse

$0. 3a8e you tayes?' which country=

$2. 3a8e you tayes?' e1plain ully7

$5. ;re any o your relati8es employed -y a pu-lic international or4aniAation= YE# NOI answer is >yes?' 4i8e the ollowin4 in ormation7

N;&E Relationship Name o International Or4aniAation

$6. "hat is your pre erred ield o wor

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( . E!:@;TION' Gi8e ull details D N.B. Please 4i8e e1act titles o de4rees in ori4inal lan4ua4e. Please do not translate or equate to other de4rees.

;. :ni8ersity or equi8alent N;&E' PL;@E ;N! @O:NTRY

Please 4i8e complete address.;TTEN!E! %RO&*TO !EGREE# and ;@;!E&I@

!I#TIN@TION# OBT;INE!&;IN @O:R#E O% #T:!Y

&onth*Year &onth*Year

B. #@3OOL# OR OT3ER %OR&;L TR;INING OR E!:@;TION %RO& ;GE $ )e.4.' hi4h school' technical school or apprenticeship+ N;&E' PL;@E ;N! @O:NTRY

Please 4i8e complete address. TYPEYE;R# ;TTEN!E! @ERTI%I@;TE# OR !IPLO&;#

OBT;INE!%RO& TO

(/. LI#T PRO%E##ION;L #O@IETIE# ;N! ;@TI ITIE# IN @I I@' P:BLI@ OR INTERN;TION;L ;%%;IR#

(0. LI#T ;NY #IGNI%I@;NT P:BLI@;TION# YO: 3; E "RITTEN (DO NOT ATTACH)

(2. E&PLOY&ENT RE@OR!7 #tartin4 with your present post' list in RE ER#E OR!ER e8ery employment you ha8e had. :se a separate -loc< or each post.Include also ser8ice in the armed orces and note any period durin4 which you were not 4ain ully employed. I you need more space' attach additional pa4es o thesame siAe. Gi8e -oth 4ross and net salaries per annum or your last or present post.

;. PRE#ENT PO#T )L;#T PO#T' I% NOT PRE#ENTLY IN E&PLOY&ENT+

%RO& TO #;L;RIE# PER ;NN:& EF;@T TITLE O% YO:R PO#T7 &ONT3*YE;R

&ONT3*YE;R

#T;RTING

%IN;L

N;&E O% E&PLOYER7

TYPE O% B:#INE##

;!!RE## O% E&PLOYER7

N;&E O% #:PER I#OR

NO. ;N! IN! O% E&PLOYEE##:PER I#E! BY YO:7

RE;#ON %OR LE; ING

!E#@RIPTION O% YO:R !:TIE#7

P.$$ ),C99+CE

(

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B. PRE IO:# PO#T# )IN RE ER#E OR!ER+

%RO& TO #;L;RIE# PER ;NN:& EF;@T TITLE O% YO:R PO#T7

&ONT3*YE;R &ONT3*YE;R #T;RTING %IN;L

N;&E O% E&PLOYER7

TYPE O% B:#INE##7

;!!RE## O% E&PLOYER7

N;&E O% #:PER I#OR7

NO. ;N! IN! O% E&PLOYEE##:PER I#E! BY YO:7

RE;#ON %OR LE; ING7

!E#@RIPTION O% YO:R !:TIE#

%RO& TO #;L;RIE# PER ;NN:& EF;@T TITLE O% YO:R PO#T7

&ONT3*YE;R &ONT3*YE;R #T;RTING %IN;L

N;&E O% E&PLOYER7

TYPE O% B:#INE##7

;!!RE## O% E&PLOYER7

N;&E O% #:PER I#OR7

NO. ;N! IN! O% E&PLOYEE##:PER I#E! BY YO:7

RE;#ON %OR LE; ING7

!E#@RIPTION O% YO:R !:TIE#

%RO& TO #;L;RIE# PER ;NN:& EF;@T TITLE O% YO:R PO#T7

&ONT3*YE;R &ONT3*YE;R #T;RTING %IN;L

N;&E O% E&PLOYER7

TYPE O% B:#INE##7

;!!RE## O% E&PLOYER7 N;&E O% #:PER I#OR7 NO. ;N! IN! O% E&PLOYEE##:PER I#E! BY YO:7

RE;#ON %OR LE; ING7

!E#@RIPTION O% YO:R !:TIE#

P.$$ ),C99+CE

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(5. 3; E YO: ;NY OB E@TION# TO O:R &; ING INH:IRIE# O% YO:R PRE#ENT E&PLOYER= YE# NO(6. ;RE YO: NO" OR 3; E YO: E ER BEEN ; @I IL #ER ;NT IN YO:R GO ERN&ENT # E&PLOY= YE# NO

I answer is >yes?' "3EN=

,9. RE%EREN@E#7 List three persons' not related to you' and are not current :nited Nations sta mem-ers' who are amiliar with your character and quali ications. Do not repeat names of supervisors isted under Item 2!.

%:LL N;&E %:LL ;!!RE## B:#INE## OR O@@:P;TION

,$. #T;TE ;NY OT3ER RELE ;NT %;@T#. IN@L:!E IN%OR&;TION REG;R!ING ;NY RE#I!EN@E O:T#I!E T3E @O:NTRY O%YO:R N;TION;LITY.

,(. 3; E YO: E ER BEEN ;RRE#TE!' IN!I@TE!' OR #:&&ONE! INTO @O:RT ;# ; !E%EN!;NT IN ; @RI&IN;L PRO@EE!ING' OR@ON I@TE!' %INE! OR I&PRI#ONE! %OR T3E IOL;TION O% ;NY L;" )e1cludin4 minor tra ic 8iolations+= YE# NO

I >yes?' 4i8e ull particulars o each case in an attached statement.

,,. OT3ER ;GEN@IE# O% T3E :NITE! N;TION# #Y#TE& &;Y BE INTERE#TE! IN O:R ;PPLI@;NT#. !O YO: 3; E ;NY OB E@TION TOYO:R PER#ON;L 3I#TORY %OR& BEING &;!E ; ;IL;BLE TO T3E&= YE# NO

, . I certi y that the statements made -y me in answer to the ore4oin4 questions are true' complete and correct to the -est o my