9
UNITED NATIONS DEVELOPMENT PROGRAMME Personal History Form INSTRUCTIONS: Please anser ea!" #$estion !learly an% !om&letely' Ty&e or &rint in in(' Rea% !are)$lly an% )ollo all %ire!tions' I) yo$ nee% more s&a!e* atta!" a%%itional &a+es o) t"e same si,e' -' Family name .s$rname/  0' First names  1' Mai%en name* i) a&&li!a2le  3' Date o) 2irt" day month year  4' Pla!e o) 2irt"  5' Nationality at 2irt"  6' List all yo$r !$rrent nationality.ies/  7' Gen%er Male Female 8' Marital stat$s Single Married Separated Widow(er) Divorced -9' Entry into United Nations service might require assignment and travel to any area o the world in which the United Nations has responsi!ilities" Do you have#e$perience any condition#situation which might limit your prospective ield o wor% or your a!ility to engage in air travel& No 'e s 'e s* please descri!e+ --' Permanent a%%ress  -0' Present a%%ress i dierent rom that indicated in !o$ ,,  -1' Tele&"one n$m2ers -ome#Mo!ile.  Wor%. /e lephone No" /e lephone No" -3' Personal an%or &ro)essional e;mail a%%ress: -4' -ave you any dependents& 'e s No the answer is 0'es1* give the ollowing inormation+ Name  Date o !irth 2elationship Name Date o !irth 2elationship  -5' -ave you ta%en up legal permanent residence status in any country other than that o your nationality& No 'es 0'es1* which country(ies)& -6' -ave you ta%en any steps towards changing your present nationality&  No 'e s 0'es1* e$plain ully+ -7'  3re any o your amily me m!ers (sp ouse#par tner* ather#moth er* ! rother#sister * son#da ughter) e mployed in the UN 4ommon System* including UND5& 'e s No 'e s1* give the ollowing inormation+ Name Relations"i& Name o) Or+ani,ation < D$ty Station  -8' Do yo$ "a=e any ot"er .e>ten%e%/ )amily mem2ers em&loye% 2y UNDP?  No 'e s 'es1* give the ollowing inormation+ Name Relations"i& Name o) Unit < D$ty Station  09' Would you accept employment or less than si$ months& 'es No 0-' -ave you !een interviewed or any UND5 positions in the last ,6 months& so* or which post(s)& 00' Lan+$a+es @  3!ility to ope rate in the listed langu age(s) in a wor% envir onment 5,, 7 ,8#9:#,, ,

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UNITED NATIONS DEVELOPMENT PROGRAMME

Personal History Form

INSTRUCTIONS: Please anser ea!" #$estion !learly an% !om&letely' Ty&e or &rint in in(' Rea% !are)$lly an%)ollo all %ire!tions' I) yo$ nee% more s&a!e* atta!" a%%itional &a+es o) t"e same si,e'

-' Family name .s$rname/ 

0' First names 

1' Mai%en name* i) a&&li!a2le 

3' Date o) 2irt"day month year  

4' Pla!e o) 2irt"

 

5' Nationality at2irt" 

6' List all yo$r !$rrentnationality.ies/ 

7' Gen%er 

Male Female

8' Marital stat$s Single Married Separated Widow(er) Divorced

-9'  Entry into United Nations service might require assignment and travel to any area o the world in which the United

Nations has responsi!ilities" Do you have#e$perience any condition#situation which might limit your prospective ield owor% or your a!ility to engage in air travel&

No 'es 'es* please descri!e+

--' Permanent a%%ress 

-0' Present a%%ress i dierent romthat indicated in !o$ ,, 

-1' Tele&"one n$m2ers-ome#Mo!ile. Wor%.

/elephone No" /elephone No" -3' Personal an%or &ro)essional e;maila%%ress:

-4' -ave you any dependents& 'es No the answer is 0'es1* give the ollowing inormation+

Name

 

Date o !irth 2elationship Name Date o !irth 2elationship 

-5' -ave you ta%en up legal permanent residence status in

any country other than that o your nationality&No 'es 0'es1* which country(ies)&

-6' -ave you ta%en any steps towards changing your

present nationality& No 'es 0'es1* e$plain ully+

-7'  3re any o your amily mem!ers (spouse#partner* ather#mother* !rother#sister* son#daughter) employed in the UN4ommon System* including UND5& 'es No 'es1* give the ollowing inormation+

Name Relations"i& Name o) Or+ani,ation < D$ty Station

 

-8'  Do yo$ "a=e any ot"er .e>ten%e%/ )amily mem2ers em&loye% 2y UNDP?  No 'es 'es1* give theollowing inormation+

Name Relations"i& Name o) Unit < D$ty Station

 

09' Would you accept employment or less than si$ months&'es No

0-' -ave you !een interviewed or any UND5 positions inthe last ,6 months& so* or which post(s)&

00' Lan+$a+es @  3!ility to operate in the listed language(s) in a wor% environment

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in%i!ate mot"erton+$e -st

Rea% rite S&ea( Un%erstan%

  none

 limited

 wor%ing %nowledge

 proicient

 none

 limited

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 proicient

 none

 limited

 wor%ing %nowledge

 proicient

 none

 limited

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  none

 limited

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 none

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 none

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 none

 limited

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  none

 limited

 wor%ing %nowledge

 proicient

 none

 limited

 wor%ing %nowledge

 proicient

 none

 limited

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 none

 limited

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  none

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 none

 limited

 wor%ing %nowledge

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 none

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 none

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none limited

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 none limited

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 none limited

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 none limited

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  none

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 none

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 none

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 none

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  none

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01' For ;eneral Service support level posts only* indicate i you have passed the ollowing tests+

UN#3S3/ < 3dministrative Support 3ssessment /est (ormerly %nown as clerical test)+No 'es i 0'es1* date ta%en+

UND5#3F/ < UND5 3ccountancy and Finance /est+ No 'es i 0'es1* date ta%en+

03' EDUCATION+ ;ive ull details 7 N= 5lease give e$act titles o degrees in original language

Degrees claimed in the >o! application (even i they are not a requirement or the post) must !e completed at the time othe application"

UND5 only recogni?es degrees and diplomas rom educational institutions that have !een recogni?ed or otherwiseapproved !y competent authorities at the time that they were o!tained" Degrees requiring little or no actual course wor%*degrees awarded or payment o ees only* and degrees granting su!stantial credits or 0lietime achievements1 or0lie#wor% e$perience1 will normally not !e recogni?ed" ncomplete degrees are unaccepta!le to UND5* regardless owhether they are associated with a recogni?ed higher educational institution"

 3" @ist all educational institutions attended* including secondary school* and diplomas#degrees or equivalent qualiicationso!tained (highest level education irst)" ;ive the e$act name o the institution and the title o degrees* diplomas* etc"(5lease do not translate or indicate equivalent degrees)"

 

Name* &la!e an% !o$ntry

Atten%e% )romto

MoBear Mo' Bear 

De+rees Di&lomas

o2taine%

Main !o$rse o) 

st$%y

In &erson or

onlineremote? 

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=" Post;#$ali)i!ation trainin+ !o$rses learnin+ a!ti=ities

Name* &la!e an% !o$ntry Ty&e Atten%e% )romtoMoBear Mo' Bear 

Certi)i!ates or Di&lomaso2taine%

In &erson oronlineremote?

 

4" UN Lan+$a+e Pro)i!ien!y E>ams .i) any/

 

D" UNDP Certi)i!ation Pro+rammes .i) any/

 

04' List mem2ers"i& o) &ro)essional so!ieties an% a!ti=ities in !i=i!* &$2li! or international a))airs

 

05' List any si+ni)i!ant &$2li!ations yo$ "a=e ritten .%o not atta!" t"em/ or any s&e!ial re!o+nitions yo$ "a=ere!ei=e%

 

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06' -ave you already !een issued a UN nde$ Num!er& No 'es 0'es1* please indicate this num!er+

07' EMPLOBMENT RECORD: Starting with your present post* list in reverse order every employment you have had" Usea separate !loc% or each employment" nclude service in the armed orces and note any period during which you were notgainully employed" you need more space* attach additional pages o the same si?e" 5rovide gross salary per annumand in%i!ate !$rren!y or your last or present post"

 3re you a current or ormer UNB& 'es No 1'es1* please indicate roster num!er+

 3" PRESENT POST .Last &ost* i) not &resently em&loye%/

 F2CM /C S3@32ES 5E2 3NNUM FUN4/CN3@ //@E+ 3s speciied in your @etter o 3ppointment#4ontract+UN grade o your post (i applica!le)+(do not indicate equivalency)@ast UN step in your post (i applica!le)+

Month#'ear  

Month#'ear  

Starting (gross) 

Final(gross) 

N3ME CF EM5@C'E2+ /'5E CF =USNESS+

EM5@C'MEN/ /'5E+Full time+5art /ime+ (

 

)

Ty&e o) !ontra!t:

  ,99 Series

5ermanent

  F/3

  S4

699 series

 ndeinite

 /3

 UNB

  3@D#A99 series

  4ontinuing

  SS3 # 4

  Cther

 3DD2ESS CF EM5@C'E2 

N3ME CF SU5E2BSC2+E7mail 3ddress and /elephone No" o Supervisor+ 

Do#did you supervise sta& so+

Num!er o proessional sta supervised+Num!er o support sta supervised+

Description o your duties and related accomplishments+

2eason or leaving+

=" PREVIOUS POSTS .In re=erse or%er i'e' most re!ent &ost )irst/

 F2CM /C S3@32ES 5E2 3NNUM FUN4/CN3@ //@E+ 3s speciied in your @etter o

 3ppointment#4ontract+UN ;rade o your post (i applica!le)+(do not indicate equivalency)@ast UN step in your post (i applica!le)+

Month#'ear  

Month#'ear  

Final(gross) 

N3ME CF EM5@C'E2 

/'5E CF =USNESS+

EM5@C'MEN/ /'5E+Full time+5art /ime+ (  )

Ty&e o) !ontra!t:

  ,99 Series

5ermanent

  F/3

  S4

699 series

 ndeinite

 /3

 UNB

  3@D#A99 series

  4ontinuing

  SS3 # 4

  Cther

 3DD2ESS CF EM5@C'E2 

N3ME CF SU5E2BSC2+E7mail 3ddress and /elephone No" o Supervisor+

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Did you supervise sta& so+Num!er o proessional sta supervised+Num!er o support sta supervised+

Description o your duties and related accomplishments+

2eason or leaving+ 

F2CM /C S3@32ES 5E2 3NNUM FUN4/CN3@ //@E+ 3s speciied in your @etter o 3ppointment#4ontract+UN ;rade o your post (i applica!le)+(do not indicate equivalency)@ast UN step in your post (i applica!le)+

Month#'ear  

Month#'ear  

Final(gross) 

N3ME CF EM5@C'E2 

/'5E CF =USNESS+

EM5@C'MEN/ /'5E+Full time+5art /ime+ (  )

Ty&e o) !ontra!t:

  ,99 Series

5ermanent

  F/3

  S4

699 series

 ndeinite

 /3

 UNB

  3@D#A99 series

  4ontinuing

  SS3 # 4

  Cther

 3DD2ESS CF EM5@C'E2 

N3ME CF SU5E2BSC2+E7mail 3ddress and /elephone No" o Supervisor+

Did you supervise sta& so+Num!er o proessional sta supervised+Num!er o support sta supervised+

Description o your duties and related accomplishments+

2eason or leaving+ 

F2CM /C S3@32ES 5E2 3NNUM FUN4/CN3@ //@E+ 3s speciied in your @etter o 3ppointment#4ontract+UN ;rade o your post (i applica!le)+(do not indicate equivalency)@ast UN step in your post (i applica!le)+

Month#'ear  

Month#'ear  

Final(gross) 

N3ME CF EM5@C'E2 /'5E CF =USNESS+

EM5@C'MEN/ /'5E+Full time+

5art /ime+ ( 

)Ty&e o) !ontra!t:

  ,99 Series

5ermanent

  F/3

  S4

699 series

 ndeinite

 /3

 UNB

  3@D#A99 series

  4ontinuing

  SS3 # 4

  Cther

 3DD2ESS CF EM5@C'E2 

N3ME CF SU5E2BSC2+E7mail 3ddress and /elephone No" o Supervisor+

Did you supervise sta& so+Num!er o proessional sta supervised+

Num!er o support sta supervised+

Description o your duties and related accomplishments+

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2eason or leaving+ 

F2CM /C S3@32ES 5E2 3NNUM FUN4/CN3@ //@E+ 3s speciied in your @etter o 3ppointment#4ontract+UN ;rade o your post (i applica!le)+(do not indicate equivalency)@ast UN step in your post (i applica!le)+

Month#'ear  

Month#'ear  

Final(gross) 

N3ME CF EM5@C'E2 

/'5E CF =USNESS+

EM5@C'MEN/ /'5E+Full time+5art /ime+ (  )

Ty&e o) !ontra!t:

  ,99 Series

5ermanent

  F/3

  S4

699 series

 ndeinite

 /3

 UNB

  3@D#A99 series

  4ontinuing

  SS3 # 4

  Cther

 3DD2ESS CF EM5@C'E2 

N3ME CF SU5E2BSC2+E7mail 3ddress and /elephone No" o Supervisor+

Did you supervise sta& so+Num!er o proessional sta supervised+Num!er o support sta supervised+

Description o your duties and related accomplishments+

2eason or leaving+ 

F2CM /C S3@32ES 5E2 3NNUM FUN4/CN3@ //@E+ 3s speciied in your @etter o 3ppointment#4ontract+UN ;rade o your post (i applica!le)+

(do not indicate equivalency)@ast UN step in your post (i applica!le)+

Month#'ear  

Month#'ear  

Final(gross)

 

N3ME CF EM5@C'E2 

/'5E CF =USNESS+

EM5@C'MEN/ /'5E+Full time+5art /ime+ (  )

Ty&e o) !ontra!t:

  ,99 Series

5ermanent

  F/3

  S4

699 series

 ndeinite

 /3

 UNB

  3@D#A99 series

  4ontinuing

  SS3 # 4

  Cther   3DD2ESS CF EM5@C'E2

 

N3ME CF SU5E2BSC2+E7mail 3ddress and /elephone No" o Supervisor+ 

Did you supervise sta& so+Num!er o proessional sta supervised+Num!er o support sta supervised+

Description o your duties and related accomplishments+

2eason or leaving+ 

F2CM /C S3@32ES 5E2 3NNUM FUN4/CN3@ //@E+ 3s speciied in your @etter o 3ppointment#4ontract+UN ;rade o your post (i applica!le)+(do not indicate equivalency)@ast UN step in your post (i applica!le)+

Month#'ear  

Month#'ear  

Final(gross) 

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N3ME CF EM5@C'E2 /'5E CF =USNESS+

EM5@C'MEN/ /'5E+Full time+5art /ime+ (  )

Ty&e o) !ontra!t:

  ,99 Series

5ermanent

  F/3  S4

699 series

 ndeinite

 /3 UNB

  3@D#A99 series

  4ontinuing

  SS3 # 4  Cther

 3DD2ESS CF EM5@C'E2 

N3ME CF SU5E2BSC2+E7mail 3ddress and /elephone No" o Supervisor+ 

Did you supervise sta& so+Num!er o proessional sta supervised+Num!er o support sta supervised+

Description o your duties and related accomplishments+

2eason or leaving+ 

F2CM /C S3@32ES 5E2 3NNUM FUN4/CN3@ //@E+ 3s speciied in your @etter o 3ppointment#4ontract+UN ;rade o your post (i applica!le)+(do not indicate equivalency)@ast UN step in your post (i applica!le)+

Month#'ear  

Month#'ear  

Starting(gross) 

Final(gross) 

N3ME CF EM5@C'E2 

/'5E CF =USNESS+

EM5@C'MEN/ /'5E+Full time+5art /ime+ (  )

Ty&e o) !ontra!t:

  ,99 Series

5ermanent

  F/3

  S4

699 series

 ndeinite

 /3

 UNB

  3@D#A99 series

  4ontinuing

  SS3 # 4

  Cther  

 3DD2ESS CF EM5@C'E2 

N3ME CF SU5E2BSC2+E7mail 3ddress and /elephone No" o Supervisor+ 

Did you supervise sta& so+Num!er o proessional sta supervised+Num!er o support sta supervised+

Description o your duties and related accomplishments+

2eason or leaving+ 

F2CM /C S3@32ES 5E2 3NNUM FUN4/CN3@ //@E+ 3s speciied in your @etter o 3ppointment#4ontract+UN ;rade o your post (i applica!le)+(do not indicate equivalency)@ast UN step in your post (i applica!le)+

Month#'ear  

Month#'ear  

Starting(gross) 

Final(gross) 

N3ME CF EM5@C'E2 

/'5E CF =USNESS+

EM5@C'MEN/ /'5E+Full time+5art /ime+ (  )

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Ty&e o) !ontra!t:

  ,99 Series

5ermanent

  F/3

  S4

699 series

 ndeinite

 /3

 UNB

  3@D#A99 series

  4ontinuing

  SS3 # 4

  Cther  

 3DD2ESS CF EM5@C'E2 

N3ME CF SU5E2BSC2+E7mail 3ddress and /elephone No" o Supervisor+ 

Did you supervise sta& so+Num!er o proessional sta supervised+Num!er o support sta supervised+

Description o your duties and related accomplishments+

2eason or leaving+ 

F2CM /C S3@32ES 5E2 3NNUM FUN4/CN3@ //@E+ 3s speciied in your @etter o 3ppointment#4ontract+UN ;rade o your post (i applica!le)+

(do not indicate equivalency)@ast UN step in your post (i applica!le)+

Month#'ear  

Month#'ear  

Starting(gross)

 

Final(gross)

 

N3ME CF EM5@C'E2 /'5E CF =USNESS+

EM5@C'MEN/ /'5E+Full time+5art /ime+ (  )

Ty&e o) !ontra!t:

  ,99 Series

5ermanent

  F/3

  S4

699 series

 ndeinite

 /3

 UNB

  3@D#A99 series

  4ontinuing

  SS3 # 4

  Cther  

 3DD2ESS CF EM5@C'E2 

N3ME CF SU5E2BSC2+E7mail 3ddress and /elephone No" o Supervisor+ 

Did you supervise sta& so+Num!er o proessional sta supervised+Num!er o support sta supervised+

Description o your duties and related accomplishments+

2eason or leaving+ 

08' -ave you any o!>ections to our ma%ing inquiries o+(a) your present employer& No 'es(!) your previous employers& No 'es

19' 3re you now* or have you ever !een* a national civil servant in your government&No 'es

'es* ndicate dates o service+ Functions+ 4ountry+

1-' 2eerences+ list t"ree persons not related to you who are amiliar with your character and qualiications and who may!e contacted or a reerence

UND5 will not see% a reerence rom yourcurrent

employer without o!taining prior consent" -owever* please note thatUND5 may see% reerences rom your ormer employers"

Full Name Full 3ddress* including E7Mail 3ddressand /elephone Num!er 

Name o Crgani?ation*=usiness or Cccupation

 

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10' State any other relevant acts in support o your application" nclude inormation regarding any periods o residenceoutside the country o your nationality 

11' -ave you ever !een convicted* ined* or imprisoned or the violation o any law (e$cluding minor traic violations)&No 'es 0'es1* give ull particulars o each case in an attached statement

13' -ave you ever had disciplinary measures imposed on you* including dismissal or separation rom service* on thegrounds o misconduct&No 'es 0'es1* give ull particulars o each case in an attached statement"

14' -ave you ever !een separated rom service on the grounds o unsatisactory perormance&

No 'es 0'es1* give ull particulars o each case in an attached statement"

15'  certiy that the inormation have provided in the present document is true* complete and correct to the !est o my%nowledge" understand that any misrepresentation or material omission made in this document may lead to thetermination o my appointment or to dismissal" understand this also applies to any other inormation or documentrequested !y the Crgani?ation or the purpose o my recruitment to and employment with UND5"

n connection with this application* authori?e ormer employers and educational institutions to release inormation a!outmy !ac%ground to UND5 or its agent" My signature !elow releases the aoresaid parties providing inormation a!out merom any lia!ility whatsoever in collecting and disseminating the inormation o!tained"

DATE+ SIGNATURE+ IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII 

Note: 

 3pplications or employment at UND5 must include a completed and signed 5ersonal -istory orm (5",,)" =y su!mitting a5ersonal -istory orm* the applicant authori?es UND5 or its agent to veriy and validate all inormation provided in the 5",,"/he 5",, orm is not valid without signature" /he signed 5",, orm serves to release any party cited in the orm rom anylia!ility whatsoever or releasing inormation to UND5 or its agent"

'ou may !e requested to provide documentary evidence o the statements you have made a!ove" Do not* however* sendany documentary evidence until you have !een as%ed to do so and* in any event* do not su!mit the originals o anyreerences* testimonials or certiicates o academic achievement unless they have !een o!tained or the sole use o UND5"

Degrees#4ertiicates are in oreign language* you may !e required to provide oicial English translation at time o request"

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