Personal History Form

Personal History Form
INSTRUCTIONS: Please answer each question clearly and completely. Type or print in ink. Read carefully and follow
all directions. If you need more space, attach additional pages of the same size.
1. Family name (surname) 2. First names 3. Maiden name, if applicable

Barbosa dos Santos Patrícia
4. Date of Birth 5. Place of birth 6. Nationality at 7. List all your current 8. Gender
day month year birth nationality(ies)
28 02 1984 Campina Grande Brazilian Male Female
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?
No Yes If "yes" please describe:

11. Permanent address 12. Present address if different from 13. Office Telephone number
Alfredo Alves de Araújo street, that indicated in box 11. Home/Mobile; +55 (83) 98830-0024
nº 453 Work;
Telephone No. +55 (83) 3335- Telephone No. 14. Personal and/or professional e-mail
1237 address: patxizjoplin@gmail.com;
palavracaoconsultoria@gmail.com
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 17. Have you taken any steps towards changing your
any country other than that of your nationality? present nationality?
No Yes No Yes
if “Yes”, which country(ies)? if “Yes”, explain fully:
18. Are any of your family members (spouse/partner, father,/mother, brother/sister, son/daughter) employed in the UN
common system, including UN Women? Yes No if answer is "yes”, give the following information:
Name Relationship Name of Organization

19. Do you have any other (extended) family members in UN Women? No Yes if answer is "yes”, give the
following information:
Name Relationship
1

20. Would you accept employment for less than six months? 21. Have you been interviewed for any UN Women positions
Yes No in the last 12 months? If so, for which post(s)?
22. Languages - Ability to operate in the listed language(s) in a work environment

mother tongue
1st
Read Write Speak Understand
Brazilian none none none none
Portuguese limited limited limited limited
working knowledge working knowledge working knowledge working knowledge
proficient proficient proficient proficient
English none none none none
limited limited limited limited
Spanish none none none none
none none none none
none none none none
none none none none
none none none none
23. For support General Service level posts only, indicate if you passed the following tests:
ASAT – Administrative Support Assessment Test (formerly known as clerical test): No Yes if “Yes”, date taken
UN Accounting Assistant Exam : No Yes No Yes if “Yes”, date taken
24. EDUCATION: Give full details - NB Please give exact titles of degrees in original language
A. List all institutions of learning attended since age 14 and diplomas/degrees or equivalent qualifications obtained (highest
education first). Give the exact name of institution and title of degrees, diplomas, etc. (Please do not translate or equate to
other degrees.)
Attended From/To Certificates, diplomas or Main course of study
Name, place and country Mo/Year Mo. /Year degrees and academic
distinctions obtained
Universidade Estadual da 03/2013 09/2015 Título de Mestre em Memória e Estudos Culturais
Paraíba / Campina Grande Literatura e
- Paraíba / Brasil Interculturalidade
Universidade Estadual da 06/2006 01/2011 Título de Licenciada em Literatura Dramática / Crítica

Paraíba / Campina Grande Letras - Língua Literária / Literatura e Sociedade
- Paraíba / Brasil Portuguesa
Escola Estadual de Ensino 02/2003 06/2004 Certificado de Conclusão Ensino Médio

Fundamental e Médio Maria de Ensino Médio -
Emília Oliveira de Almeida / Modalidade Supletivo
Campina Grande / Brasil
2
Colégio Alfredo Dantas / 02/1995 12/1999 Certificado de conclusão Ensino Fundamental
Campina Grande / Brasil do Ensino Fundamental

B. Post-qualification training courses / learning activities

Name, place and country Type Attended From/To Certificates or
Mo/Year Mo. /Year Diplomas obtained
Universidade de Brasília / Curso de Capacitação a 08/2017 10/2017 Certificado do curso de
Brasília / Brasil Distância capacitação a distância de
avaliadores de redações. - ENEM
- 2017
Universidade Estadual da Curso de extensão 03/2015 12/2015 Certificado de conclusão do curso
Paraíba / Campina Grande / de Libras nos níveis I e II.
Brasil
Universidade Estadual da Oficina de Teatro 11/2015 11/2015 Oficina de Teatro: O ator e o ato
Paraíba criador, ministrada pelo ator e
diretor Chico Oliveira
Universidade Estadual da Oficina de Teatro 11/2015 11/2015 A poesia do corpo em ação,

Paraíba / Campina Grande / ministrada atriz e diretora Regina
Brasil Albuquerque
FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT
Universidade de Brasília / Curso de Formação FORMTEX FORMTEXT Certificado do Curso de
Brasília / Brasil Continuada T 10/2014 Formação Continuada para
FORMTEX Avaliadores de Redações - ENEM
T 2014
08/2014

FORMTEXT Universidade FORMTEXT Curso de FORMTEXT FORMTEXT Certificado do Curso
de Brasília / Brasília / Formação Continuada FORMTEXT 10/2013 de Formação Continuada para
Brasil 08/2013 Avaliadores de Redações - ENEM
2013
Universidade Estadual da Minicurso 2008 2008 "Gêneros multimodais,
Paraíba / Campina Grande / multiletramento e ensino de
Brasil leitura”. XIV Semana de Letras
Universidade Federal de Minicurso 2008 2008 “Dramaturgia para crianças:

Campina Grande / Campina estudo de obras e sugestões
Grande / Brasil metodológicas”. II Encontro
Nacional Sobre Literatura Infanto-
Juvenil e Ensino
3

C. UN Language Proficiency Exams (if any)

D. UN Certification Programmes (if any)

25. List membership of professional societies and activities in civic, public or international affairs

26. List any significant publications you have written (do not attach them) or any special recognition
I carried out an independent publication named "Vamos nos conhecer e conhecer nosso poder" for groups of women,
schools, collectives,on public policies for women fro a plan drawn up by the local government.
I created an independent publisher named Coiote Cartonera with the support of the independent publisher Candeeiro
Cartonera from Caruaru, Pernambuco who aims to strengthen the taste for reading and writing to spread local authors and
promote citizenship.

27. EMPLOYMENT RECORD: Starting with your present post, list in reverse order every employment you have had. Use a
separate block for each employment. Include also service in the armed forces and note any period during which you were not
gainfully employed. If you need more space, attach additional pages of the same size. Provide gross and indicate
denomination salary per annum for your last or present post.
Have you already been issued a UN Index Number? No Yes If yes, please indicate this number:
Are you a current or former UNV? Yes No If yes, please indicate roster number:
A. PRESENT POST (LAST POST, IF NOT PRESENTLY IN EMPLOYMENT)
FROM TO SALARIES PER ANNUM FUNCTIONAL TITLE: As specified in your Letter of
Month/Year Month/Year Starting (gross) Final Appointment/Contract:
(gross) UN Grade of your post (if applicable):
Last UN step in your post (if applicable):
NAME OF EMPLOYER: TYPE OF BUSINESS:

EMPLOYMENT TYPE:
Full time:
Part Time: ( %)
Type of contract:
100 Series 200 series ALD/300 series

Permanent Indefinite Continuing
FTA TA SSA
SC UNV Other
ADDRESS OF EMPLOYER NAME OF SUPERVISOR:
Email Add. and/or Telephone No. Of Supervisor:
Number of Professional Staff Reason for

Supervised: leaving:
Number of Support Staff
Supervised:
DESCRIPTION OF YOUR DUTIES AND RELATED ACCOMPLISHMENTS
4

B. PREVIOUS POSTS (IN REVERSE ORDER - I.E. MOST RECENT POSTS FIRST)
Month/Year Month/Year Final Appointment/Contract: Outsourced
12/2016 06/2017 (gross) UN Grade of your post (if applicable):
R$ Last UN step in your post (if applicable):
1000,00
NAME OF EMPLOYER TYPE OF BUSINESS:
Revista Brasileira de Agroecologia - RBA
EMPLOYMENT TYPE:
Full time:
Part Time: (40%)
Type of contract:

FTA TA SSA
SC UNV Other By demand
ADDRESS OF EMPLOYER NAME OF SUPERVISOR: Joel Donazzolo
Endereço: Av. Bento Gonçalves, 7712 - Prédio 41301 - Email Add. and/or Telephone No. of Supervisor:
Campus do Vale - 91540-000 - Porto Alegre - RS - Brasil joel@utfpr.edu.br

Supervised: leaving:Resources for
Number of Support Staff the service ended up
Supervised:
I was resposible for performing the spelling correction and ABNT standards and for diagraming the texts in the format of
online journal

Month/Year Month/Year Final Appointment/Contract: Voluntary
NAME OF EMPLOYER TYPE OF BUSINESS: Workshop
Núcleo de Extensão em Desenvolvimento Territorial -
NEDET EMPLOYMENT TYPE:
Full time:
Part Time: (20%)
Type of contract:

FTA TA SSA
SC UNV Other
ADDRESS OF EMPLOYER NAME OF SUPERVISOR: Renata Aires
Campus Universitário III - R. João Pessoa, S/N - Cidade Email Add. and/or Telephone No. of Supervisor:
Universitária, Bananeiras - Paraíba - Brasil ad.renataaires@gmail.com
Number of Professional Staff Reason for leaving:The

Supervised: sources for the service
Number of Support Staff ended up
Supervised: 2
I taught quilombola youth how to design projects and to acess public policies related to quilombola youth and living with
semiarid
5
Month/Year Month/Year Final Appointment/Contract: Voluntary
NAME OF EMPLOYER TYPE OF BUSINESS: Support
Núcleo de Exensão em Desenvolvimento Territorial -
NEDET EMPLOYMENT TYPE:
Full time:
Part Time: (50%)
Type of contract:

FTA TA SSA
SC UNV Other
ADDRESS OF EMPLOYER NAME OF SUPERVISOR: Renata Aires
Campus Universitário III - R. João Pessoa, S/N - Cidade Email Add. and/or Telephone No. of Supervisor:
Universitária, Bananeiras - Paraíba - Brasil ad.renataaires@gmail.com
Number of Professional Staff Reason for leaving:the

Supervised: sources ended up
Supervised: 2
i participed in actions developed with quilombola women and youth in workshops promoting autonomy and citizenship, i
made report of these events

Month/Year Month/Year Final Appointment/Contract:
765,00 Last UN step in your post (if applicable):
NAME OF EMPLOYER TYPE OF BUSINESS: Tutoring
Universidade Federal da Paraíba - UFPB Virtual
EMPLOYMENT TYPE:
Full time:
Part Time: (40%)
Type of contract:

FTA TA SSA
SC UNV Other Grant-aid
ADDRESS OF EMPLOYER NAME OF SUPERVISOR: Nayara de Almeida Adriano
Cidade Universitária, s/n - Castelo Branco III, João Pessoa Email Add. and/or Telephone No. of Supervisor:
- PB, 58051-085 - Paraíba - Brasil
Supervised: leaving:Finished the
Number of Support Staff contract
Supervised:
I aided the students of the undergraduate distance course of Letters and Libras in their activities

Month/Year Month/Year Final Appointment/Contract: Internship
380,00 Last UN step in your post (if applicable):
Fundação Universitária de Apoio ao Ensino, Pesquisa e
Extensão - FURNE EMPLOYMENT TYPE:
Full time:
Part Time: (40%)
6
Type of contract:

FTA TA SSA
SC UNV OtherGrant-aid
ADDRESS OF EMPLOYER NAME OF SUPERVISOR: Maria Cristina de Freitas Gomes
Av. Mal. Floriano Peixoto, 718 - Centro, Campina Grande - Email Add. and/or Telephone No. of
PB, 58400-180 - Paraíba - Brasil Supervisor:cristinafgomes@gmail.com

Supervised: 4 leaving:Ended the
Number of Support Staff internship
Supervised:
I took care of the arte gallery participating in educational action, receiving students from school talking about pieces of art and
reviewed the texts of the catalogs of the exhibitions of the Assis Chateaubriand Museum of Art

Month/Year Month/Year Final Appointment/Contract:
(gross) UN Grade of your post (if applicable):

EMPLOYMENT TYPE:
Full time:
Part Time: ( %)
Type of contract:

FTA TA SSA
SC UNV Other
Email Add. and/or Telephone No. of Supervisor:

Supervised:


Month/Year Month/Year Starting Final Appointment/Contract:
(gross) (gross) UN Grade of your post (if applicable):

EMPLOYMENT TYPE:
Full time:
Part Time: ( %)
Type of contract:

FTA TA SSA
SC UNV Other
7
Supervised:



EMPLOYMENT TYPE:
Full time:
Part Time: ( %)
Type of contract:

FTA TA SSA
SC UNV Other
Number of Professional Staff Reason for leaving:

Supervised:
Supervised:


EMPLOYMENT TYPE:
Full time:
Part Time: ( %)
Type of contract:

FTA TA SSA
SC UNV Other

Supervised:

28. Have you any objections to our making inquiries of: (a) your present employer? No Yes ;
8
(b) previous employers? No Yes
29. Are you now, or have you ever been, a permanent civil servant employee in your government?
No Yes If answer is "yes", WHEN?
30. References: list three persons not related to you who are familiar with your character and qualifications and who may be
contacted for a reference
FULL NAME FULL ADDRESS, including E-MAIL BUSINESS OR OCCUPATION

ADDRESS and TELEPHONE NUMBER
Maria Cristina de Freitas Gomes Av. Prof. Moraes Rego, 1235 - Cidade museóloga, Universidade Federal de
Universitária, Recife - PE, 50670-901 Pernambuco - UFPE, Centro de
(phone number: +55 81 21267380) (e- Filosofia e Ciências Humanas - CFCH,
mail: cristinafgomes2@gmail.com) Departamento de Antropologia e
Museologia
Elisa Mariana de Medeiros Nóbrega Rua Pres. Arthur Bernardes, 370, Professora na Universidade Estadual da
Bessa, João Pessoa, cep 58035300 Paraíba- UEPB, do Departamento de
(Phone number: +55 83 99999-6367) Pós-Graduação em Literatura e
(e-mail: elisammn@hotmail.com) Interculturalidade
Luciano Barbosa Justino Rua Anacleto Eloi, 288, quarenta. Professor na Universidade Estadual da
Campina Grande, PB. (Phone Number: Paraíba - UEPB, do Departamento de
+55 83 98838- 5387) (e-mail: Pós-Graduação em Literatura e
lucianobjustino@hotmail.com) Interculturalidade
31. State any other relevant facts in support of your application. Include information regarding any residence outside the
country of your nationality
32. Have you ever been convicted, fined, or imprisoned for the violation of any law (excluding minor traffic violations)?
No Yes If “Yes” give full particulars of each case in an attached statement
33. Have you ever been imposed disciplinary measures, including dismissal or separation from service, on the grounds of
misconduct?
34. Have you ever been separated from service on the ground of unsatisfactory performance?
35. 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 the UN Women Personal
History Form may lead to the termination of the appointment or to dismissal. I understand this also applies to any other
information or document requested by the Organization for the purpose of my recruitment to and employment with UN
Women.
DATE: 06/06/2018 SIGNATURE: _________________________________________
Note: You may be requested to provide documentary evidence of the statements you have made above. Do not, however,
send any documentary evidence until you have been asked to do so and, in any event, do not submit the originals of any
references, testimonials or certificates of academic achievement unless they have been obtained for the sole use of UN
Women.

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Personal History Form

1. Family name (surname) 2. First names 3. Maiden name, if applicable

9. Marital status Single Married Separated Widow(er) Divorced

No Yes If "yes" please describe:

Name Date of birth Relationship Name Date of birth Relationship

22. Languages - Ability to operate in the listed language(s) in a work environment

UN Accounting Assistant Exam : No Yes No Yes if “Yes”, date taken

Universidade Estadual da 06/2006 01/2011 Título de Licenciada em Literatura Dramática / Crítica

Escola Estadual de Ensino 02/2003 06/2004 Certificado de Conclusão Ensino Médio

B. Post-qualification training courses / learning activities

Universidade Estadual da Oficina de Teatro 11/2015 11/2015 A poesia do corpo em ação,

Universidade Federal de Minicurso 2008 2008 “Dramaturgia para crianças:

C. UN Language Proficiency Exams (if any)

D. UN Certification Programmes (if any)

100 Series 200 series ALD/300 series

Number of Professional Staff Reason for

100 Series 200 series ALD/300 series

Number of Professional Staff Reason for

FROM TO SALARIES PER ANNUM FUNCTIONAL TITLE: As specified in your Letter of

100 Series 200 series ALD/300 series

Number of Professional Staff Reason for leaving:The

100 Series 200 series ALD/300 series

Number of Professional Staff Reason for leaving:the

FROM TO SALARIES PER ANNUM FUNCTIONAL TITLE: As specified in your Letter of

100 Series 200 series ALD/300 series

FROM TO SALARIES PER ANNUM FUNCTIONAL TITLE: As specified in your Letter of

100 Series 200 series ALD/300 series

Number of Professional Staff Reason for

FROM TO SALARIES PER ANNUM FUNCTIONAL TITLE: As specified in your Letter of

100 Series 200 series ALD/300 series

Number of Professional Staff Reason for

FROM TO SALARIES PER ANNUM FUNCTIONAL TITLE: As specified in your Letter of

100 Series 200 series ALD/300 series

FROM TO SALARIES PER ANNUM FUNCTIONAL TITLE: As specified in your Letter of

100 Series 200 series ALD/300 series

Number of Professional Staff Reason for leaving:

FROM TO SALARIES PER ANNUM FUNCTIONAL TITLE: As specified in your Letter of

100 Series 200 series ALD/300 series

Number of Professional Staff Reason for

FULL NAME FULL ADDRESS, including E-MAIL BUSINESS OR OCCUPATION

No Yes If “Yes” give full particulars of each case in an attached statement

DATE: 06/06/2018 SIGNATURE: _________________________________________

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