P11 - P.11 (2-74) - E Do Not Write in This Space...

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P.11 (2-74) - E INSTRUCTIONS Please answer each question clearly and completely. Type or print in ink. Read carefully and follow all directions. UNITED   NATIONS PERSONAL HISTORY Do Not Write in This Space 1. Family name First name Middle name Maiden name, if any 2. Date of Birth Day Mo. Yr. 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 and travel to any area of the world in which the United Nations might have responsibilities. Have you any disabilities which might limit your prospective field of work or your ability to engage in air travel? YES NO If “yes”, please describe. 11. Permanent address 12. Present address (if different) 13. Office Telephone No. Office Fax. No E-mail: Telephone No. Telephone/Fax No. 15. Have you any dependents? YES NO If the answer is “yes”, give the following information: NAME Date of Birth Relationship NAME Date of Birth Relationship 16. Have you taken up legal permanent residence status in any country other than that of your nationality? If answer is “yes”, which country? YES NO 17. Have you taken any legal steps towards changing your present nationality? If answer is “yes”, explain fully: YES NO 18. Are any of your relatives employed by a public international organization? If answer is “yes”, give the following information:
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P11 - P.11 (2-74) - E Do Not Write in This Space...

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