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 tho same size, 1, Family name (surname) 2. First names ‘3. Maiden name, if applicable BINIBANGuILt Bean Mechurn 4, Date of Birth 5. Place of birth 6. Nationality at 7. List all your current | 8. Gender day = month year birth nationality(ies) d . ce . Male [XJ Female 28140 [1950 [Reza [lca cai one 8.Maritalstatus Single) Married [] Separated [1] widower) Divorces 10. Entry into United Nations service might require assignment and travel to any area of the world in which the Uniled ‘Nations might have responsibilities. Have you any disablities which might limit your prospective field of work or your ability to engage in air travel? No fd Yes []_it*ves" please describe: 11. Permanent address 12, Present address if different from | 13. Office Telephone number B that indicated in box 71 HomerMobile; AM RAFI ‘Work; Telephone No. Telephone No. 14, Personal andlor professional e-mail +236 address: 18. Have you any dependents? Yes [x] No] ifthe answer is "Ves", give the following information: Name. Date of birth Relationship Name Date of birth Relationship NGA Geada 24] Diy [Zowe BALANe Fabien 12 |p2} 20 | Canter WELEMGER [ea lelzoz0 | te Pos| da ttvinr2 | Gave 400 18. Have You taken up legal permanent residence status In] 47. Have you taken any slaps Towards changing your ‘any country other than that of your nationality? present nationality? No fi) Yes L] No) Yes] if "Yes", which country(ies)? if "Yes", explain fully | 18. Are any of your family members (spouse/pariner, father./mother, brother/sister, son/daughter) employed in the UN Common system, including UN Women? Yes [|] No [x] if answers "yes", give the following information I Name Relationship Name of Organization 13,,De You have any other (extended) family members in UN Women? No Dd Yes LI if answeris "yes" gve the following information: Name Relationship20 Would you accept employment for less than six months? | 27, Have you been inerviewed or any UN Women Yes J Nol] Positions in the last 12 months? If so, for which post(s)? na 22, Languages - Ability to operate in the listed language(s) in a work environment mother tongue i" Read Write eae ae Tnone Dnone none Tone Romecia | | ea Fiimtea Ciimtea limes F working knowledge | [} working knowledge | [] working knowledge | 5] working knowledge proficient proficient rofcient proficient : none ‘none none none [Prugrars limited liitea Bimites limited working knowledge | []working knowledge | []working knowledge | (J working knowledge proficient proficient proficient proficient (none none none none Soe Dlimtes iimites Ciimitea Diimiea ec [working knowledge | [1] working knowledge | F working knowledge | 5) working knowledge jalhch tesa proficient [El proficient proficient proficient none LJnone none none Olimitea Olimited O limited O limite [working knowledge | [) working knowledge | [1 working knowledge | [] working knowledge proficient proficient proficient proficient none none none none O limited O limitea Oliimitea limited [working knowledge | [] working knowledge | [] working knowledge | (] working knowledge __| B proficient proficient proficient Ooroficient (none none none (none limited Oiimitea limited Oliimitea Clworking knowiedge | [J working knowledge | C]working knowledge | 5) working knowledge Cloroficient LD oroficient Bproficient Clproticient 23. For support General Service level posts only, indicate if you passed the following Teale ASAT — Administrative Support Assessment Test (formerly known as clerical test): No ves Olit*Yes", date taken UN Accounting Assistant Exam : No [i] Yes C] No LlYes [lif*Yes*, date taken 24. EDUCATION: Give full details - NB Please give exact tiles of degrees in original language A List al institutions of leaming attended since age 14 and diplomas/degrees or equivalent qualifications obtained {highest education firs). Give the exact name of institution and tile of degrees, diplomas, ete. (Please do not translate or equate to other degrees.) Attended FromiTo Certificates, diplomas Main course of study Name, place and country | Mo/Year Mo. /Year or degrees and academic distinctions i obtained 2006 - ae Undis JOOG | Aex¥ gold Barcalaueat Grins geritant Univesity all Beatle liu a inzp] Kou: Zoe ditente 3 Eemomis [Getlim. [natin Ther gat tod [bee 2A | agen g Ecmnnce [givin oF B. Post-qualification training courses / learning activities Name, place and country | Type ‘Attended FromiTo Cortificates or - | MolYear Mo. fear Diplomas obtained 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 27, EMPLOYMENT RECORD: Starting with your present post, listin reverse order every employment you have had. Use & 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 @ UN Index Number? No iJ Yes [1 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 [10 ‘SALARIES PER ANNUM [FUNCTIONAL TITLE: As specified in your Latter of Month/Year | Month/Year | Starting (gross) | Final Appointment/Contract: Mey. LOA (gross) _ | UN Grade of your post if applicable): dolore o> Last UN step in your post (if applicable): P ae NAME OF EMPLOYER: TYPE OF BUSINESS: ste . | EMPLOYMENT TYPE: Yumentld db FarQuacm Full time: [2] PartTime ‘Type of contract: 1) 100 Series [200 series | 1) ALD/300 series | i Permanent C1 indefinite D Continuing FTA OTA ssa Osc | Cluny Gi other ‘ADDRESS OF EMPLOYER NAME OF SUPERVISOR: Thtobatol UIViREDA Email Add. andfor Telephone No. Of Supervisor: shen (Ci iyi Bi b 23340 93 bon y (Comp Houten) Numbefof Professional Staff Reason for Supervised: leaving: Number of Support Staff Supervised: 0. = DESCRIPTION OF YOUR DUTIES AND RELATED. ACCOMPLISHMENTS. ~ Fake & Sir des aclail’s aur ri ; — Willa 8 Your Uo otipewtas elo 4 — Grimes 72) pr nin fo Reclevaliletye La wrra Lig yt ns eacag Ane Eelickun 8. PREVIOUS POSTS (IN REVERSE ORDER - LE. MOST RECENT POSTS FIRST) FROM TO ‘SALARIES PER ANNUM | FUNCTIONAL TITLE: As specified in your LetterofMonthiYeer | Month/Year Final AppointmentContract Ge Pun & Hvis 2022 [Feats a (gross) | UN Grade of your post (if applicable): 2022 Last UN step in your post (if applicable): — NAME OF EMPLOYER TYPE OF BUSINESS: this awitacnt Homenite eb Tecltin Eran inne B 4 Ful time: S | Mbardkou) PartTime []( __%) Type of contract: © 100Series | ()200series | C1) ALD/200 series Di Permanent | F}indennte | F) Continuing pete oA CO ssa $ sc UNV DO other ‘ADDRESS OF EMPLOYER NAME OF SUPERVISOR: Yaula ouctio Email Add, and/or Telephone No. of Supervises ‘ pee [Mboaton | lumber of Professional Staff Reason for & Supervised: 0 leaving: hist Number of Support Staff a Supervised: 0. Baer DESCRIPTION OF YOUR DUTIES AND RELATED ACCOMPLISHMENTS © = fou Kus achaks dun fe Ips un j sa aed Gun Le DIY wm cuspectanc Do putidinrs olinhal FROM. TO SALARIES PER ANNUM | FUNCTIONAL TITLE A speciiedin yout Leer of ‘Month’Year | MonthvYear Final | AvpoinimenvContact Clana AE £ 10% (gross) | UN Grade of your post (if applicable) tae eee Last UN step in your post (if applicable) NAME OF EMPLOYER TYPE OF BUSINESS: Soa EMPLOYMENT TYPE: keten Full time: PartTime:[](__%) Type of contract: © 100 Series | 200 series | [) ALD/300 series {I Permanent | [J indefinite |) Continuing OFA Ors Cj ssa sc Ounv G other ADDRESS OF EMPLOYER NAME OF SUPERVISOR: Waxime Denia Email Add. and/or Telephone No. of Supervisor: Bow yor (Bout) rate Brisk tam Be apes) —_| Supervised: 62. Number of Support Staff Superv'sed, 5 DESCRIPTION OF YOUR DUTIES AND RELATED ACCOMPLISHMENTS: = Big Lo minim olf Da obi, Su = Rdiaggr Bo TAR at be cag ects MA. ree g = Resliger me Outer Lo Anppnticlo warning Andras sper Pin apts FROM TO SALARIES PER ANNUM] FUNCTIONAL TITLE: As speciied in your Letter of Month/Year | Month/Year Final AppointmentContract: StuPerwifeern MEAL 01020 2.0 (gross) _| UN Grade of your post (it apalteable) fe [Ek 20% Last UN step in your post (if applicable): NAMIE OF EMPLOYER TYPE OF BUSINESS: aes Fapaec Humomatilot TaQusin EMPLOYMENT TYPE Full time: PartTime:EJ(__%)Type of contract: 1 100Series | [200 series | [] ALD/300 series, Permanent | [J Indefinite | [1 Continuing FTA Ota O ssa sc Ouny ‘ADDRESS OF EMPLOYER Bom yovin (m boutin ) Other NAME OF SUPERVISOR: ‘Tanta FETTER Email Add. and/or Telephone No. of Supervisor: Reson Tor = of Professishal Staff Supervised: leaving ae Number of Support Staff 3 Supervised. AQ Pasig /Cotoat a DESCRIPTION OF YOUR DUTIES AND RELATED ACCOMPLISHMENTS E cE plomifinn is amadtoc” + Pa Xs erate ollicn eceetlins ! + Appeger £Soripe ee FROM TO, SALARIES PER ANNUM | FUNCTIONAL TITLE: As specified in your Letter of Month/Year | Month/Year Final | AppointmentGontract: Ageur TM Aanie. (gress) _| UN Grade of your post (if applicable) [Avit dol Hw 2020 I Last UN step in your post (if applicable) NAME OF EMPLOYER TYPE OF BUSINESS” al a TYPE! Full time: Juperes. Pert Time: (](__%) ‘Type of contract: 1) 100Series | 1) 200 series | ALD/300 series {Permanent | C) indefinite | ©) Continuing FTA Oma CO ssa sc UNV | O) Other ADDRESS OF EMPLOYER NAME OF SUPERVISOR: BAPAT — OLY- Cy] Email Add. andlor Telephone No. of Supervisor +236 42 Number of Professional Staff vg Reason for Ban ye | Supervised: Number of Sup Supervised: 9: leaving: Stat Derdesin DESCRIPTION OF YOUR DUTIES AI Print, frome a te ohn Ian mmaviclintiugs lie Aavou o foe Be ote IND RELATED ACCOMPLISHMENTS: é ae & Teron Vewrearte olen prpefatins FROM ‘Month/Year TO Month/Year SALARIES PER ANNUM Final (gross) FUNCTIONAL TITLE: As specified in your Letter of AppointmentiGontract 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: 1 Part Time:C](__%) Type of contract: 100 series Permanent FTA Oa O ssa Osc Ounv 2200 series © ALD/300 series Oy indefinite © Continuing ‘ADDRESS OF EMPLOYER C) Other NAME OF SUPERVISOR Emall Add. andlor Telephone No. of Supervisor.Number of Professional Staff Reason for Supervised: leaving, Number of Support Staff Supervised! DESCRIPTION OF YOUR DUTIES At ND RELATED ACCOMPLISHMENTS TO Month/Year SALARIES PER ANNUM | Final (gross) [FROM Month/Year FUNCTIONAL TITLE: As specified in your Letter of Appoint mentContract: 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: [) PartTime:[)( __%) ‘Type of contract: 100 Series © Permanent Orta TA Osc Ounv 200 series Indefinite 1D Atov300 series Oi Continuing O ssa 0 Other ADDRESS OF EMPLOYER NAME OF SUPERVISOR’ Email Add, and/or Telephone No, of Supervisor: Number of Professional Staff Supervised: Number of Support Staff Supervised: Reason for leaving: DESCRIPTION OF YOUR DUTIES At ND RELATED ACCOMPLISHMENTS FROM ‘Month/Year TO Month/Year SALARIES PER ANNUM. Starting Final (gross) (gross) FUNCTIONAL TITLE: As specified in your Letter of Appointment’Contract UN Grade of your post (if applicable) Last UN step in your post (if applicable): NAME OF EMPLOYER ‘TYPE OF BUSINESS: ENIPLOYMENT TYPE: Full time: PartTime:[](__%) ‘Type of contract: 7 100 Series | 1) 200 series ALD/300 series © Permanent | F) indefinite Continuing O eta OTA O ssa LO sc Ounv | 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 At ND RELATED ACCOMPLISHMENTSFROM. TO. SALARIES PER ANNUM | FUNCTIONAL TITLE: As specified in your Leter of Month/Year — | Month/Year | Starting Final ‘AppointmenContract (gross) (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: C] Part Time []{___%) ‘Type of contract: © to0series | [1200 series | () ALD/300 series Permanent | C)indefinite |} Contin FTA Oa Oo = Osc UNV 0 Other ‘ADDRESS OF EMPLOYER NAME OF SUPERVISOR Email Add. and/or Telephone No. of Supervisor: Number of Professional Staff Reason for leaving Supervised: Number of Support Staff Supervised: DESCRIPTION OF YOUR DUTIES AND RELATED ACCOMPLISHMENTS: FROM To. SALARIES PER ANNUM | FUNCTIONAL TITLE: As specified in your Letter of Month/Year | Month/Year | Starting Final | Appointment/Gontract: (gross) (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: C] PantTime:C}(__%) ‘Type of contract: 100 Series | [] 200series | [) ALD/300 series Permanent C1 indefinite O Continuing FTA Om O ssa 7 af {] sc Ounv C) 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: z DESCRIPTION OF YOUR DUTIES AND RELATED ACCOMPLISHMENTS: | 28. Have you any objections To our making inquiries of (a) your present employer? No [i Yes; (©) previous employers? No [%] Yes E] | 28. Are you now, or have you ever been, a permanent cil servant employee ih 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 NUYIRERE Thrbobabs [Jean Moos Jovi FEVER OT Manta Kelpxe Bove Deu, 32. Have you ever been arrested, indicted or summoned in court as a defendant in @ criminal proceeding, or convicted, fined, or imprisoned for violation of any law (excluding minor traffic violations)? No YesC] — if*Yes" Please explain 38. Have you ever been or are you currently the subject of an investigation into allegations of misconduct or wrongdoing, including though not limited to harassment (Including sexual harassment), sexual exploitation and abuse, discrimination, fraud and abuse of authority? Nofd YesC] — if*Yes' Please specify the conduct(s) 34. Have you ever been or are you currently subject to disciplinary proceedings? No[] YesC] — If*Yes" Please explain 36, Have you ever been found to have committed misconduct or wrongdoing in the workplace, including though not limited to harassment (including sexual harassment), sexual exploitation and abuse, discrimination, fraud and abuse of authority? No Yes] If'Yes" Please explain. 36, Have you ever been dismissed or separated from service from the UN system? No YesC] If"Yes" Please explain: 37. | certiy 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. | 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. | understand this also applies to any ther information or document requested by the Organization for the purpose of my recruitment to and employment with UN Women, DATE: 0/|p6(2022 SIGNATURE a 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 fo do so and, in any event, do not submit the criginals of any references, testimonials or certificates of academic achievement unless they have been obtained for the sole use of UN Women.