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Print Date: 19 April 2018 Page 1 of 8
Personal History Form
This form allows you to apply or express interest for Field positions in the General Service and National Professional
categories, for Temporary Appointments in the Professional category, or for working under one of the affiliate schemes
(UNOPS, Individual consultant or contractor, deployee, secondee, etc.).
Please complete the form carefully, answering all mandatory sections fully and as completely as possible.
Your Personal History Form will be reviewed in the near future, and you will be contacted if you are short-listed for an
interview.
Note: Please do not contact UNHCR directly regarding the status of this application.
If you need assistance in completing this form, please contact UNHCR via the email address provided in the vacancy notice or
liaise with your nearest UNHCR Office.
1. GENERAL INFORMATION (Mandatory to complete)
Last Name
Middle Name Maiden Name
First Name
2. PERSONAL INFORMATION (Mandatory to complete)
Date of Birth (dd/mm/yyyy) Gender Male Female No Selection
Marital Status Married Single Divorced Common Law Registered Partnership
Separated Widowed
3. CONTACT INFORMATION (Mandatory to complete)
Current Address
Address
City
Postal Code Country
Permanent Address
Address
City
Postal Code Country
Preferred Contact Method Email Phone Post Mail
4. PHONE NUMBERS (Mandatory to complete)
Type Country Code Telephone # Ext. Indicate which is Preferred
Home
Business
Mobile
5. EMAIL ADDRESSES (Mandatory to complete)
Type Email Address Indicate which is Preferred
Home
Business
6. NATIONALITY INFORMATION (Mandatory to complete)
NATIONALITY INFORMATION Please list all COUNTRIES as applicable
Nationalities at Birth
Current Nationalities
Permanent Residency
Print Date: 19 April 2018 Page 2 of 8
7. LETTER OF INTEREST (Mandatory to complete if applying for a specific vacancy announcement)
Please indicate the position you are applying for
Please answer the following questions.
1. How have your achievements and operational experience to date prepared you for this position?
Please refer to the job description and to the essential requirements therein. (1500 characters max)
2. Please describe any skills and competencies you have, and which may be of particular relevance to this position.
(1500 characters max)
3. How does this position align with your career aspirations? (1000 characters max)
Print Date: 19 April 2018 Page 3 of 8
8. WORK EXPERIENCE (Mandatory to complete, if any)
For all work experience, please complete as much information as possible.
Starting with your present position, list in REVERSE ORDER all employment you have had, using a separate block for each
work experience. Also include service in the armed forces. Note any period during which you were not gainfully employed.
Three blocks are provided; if you need more space, attach additional pages ensuring to give the same information requested
here.
Start Date
(dd/mm/yyyy)
End Date
(dd/mm/yyyy)
Full
Part-Time
Employer Check if ongoing
Job Title
Supervisor Name
Type of Employment
Employee Consultant Intern Self-employed
UN Volunteer Volunteer Other
If ‘Other’ please explain
Type of Workers Supervised # of Persons Supervised
Supervisor e-mail Supervisor Phone
Ending Pay Rate Amount
(Annual Net)
Currency
Reason for Leaving
Description of duties
(1200 characters max)
Employer Address line 1
Address line 2
Address line 3 Postal Code
City Country
Type of Business
Governmental Organization International Organization
Non-Governmental Organization Private Sector Other
Is this UN Experience? Yes No Grade (if applicable)
UN Index #
Is this UNHCR experience? Yes No UNHCR MSRP ID
Contract Type Fixed Term Indefinite Temporary Appointment Other Arrangement
If ‘Other Arrangement’ please indicate the Type of Arrangement
(e.g. UN Volunteer, UNOPS ICA, Individual Consultant, Intern, ICMC, Danish Refugee Council etc.)
Start Date
(dd/mm/yyyy)
End Date
(dd/mm/yyyy)
Full
Part-Time
Employer Check if ongoing
Job Title
Supervisor Name
Type of Employment
Employee Consultant Intern Self-employed
UN Volunteer Volunteer Other
If ‘Other’ please explain
Type of Workers Supervised # of Persons Supervised
Supervisor e-mail Supervisor Phone
Ending Pay Rate Amount
(Annual Net)
Currency
Reason for Leaving
Print Date: 19 April 2018 Page 4 of 8
Description of duties
(1200 characters max)
Employer Address line 1
Address line 2
Address line 3 Postal Code
City Country
Type of Business
Governmental Organization International Organization
Non-Governmental Organization Private Sector Other
Is this UN Experience? Yes No Grade (if applicable)
UN Index #
Is this UNHCR experience? Yes No UNHCR MSRP ID
Contract Type Fixed Term Indefinite Temporary Appointment Other Arrangement
If ‘Other Arrangement’ please indicate the Type of Arrangement
(e.g. UN Volunteer, UNOPS ICA, Individual Consultant, Intern, ICMC, Danish Refugee Council etc.)
Start Date
(dd/mm/yyyy)
End Date
(dd/mm/yyyy)
Full
Part-Time
Employer Check if ongoing
Job Title
Supervisor Name
Type of Employment
Employee Consultant Intern Self-employed
UN Volunteer Volunteer Other
If ‘Other’ please explain
Type of Workers Supervised # of Persons Supervised
Supervisor e-mail Supervisor Phone
Ending Pay Rate Amount
(Annual Net)
Currency
Reason for Leaving
Description of duties
(1200 characters max)
Employer Address line 1
Address line 2
Address line 3 Postal Code
City Country
Type of Business
Governmental Organization International Organization
Non-Governmental Organization Private Sector Other
Is this UN Experience? Yes No Grade (if applicable)
UN Index #
Is this UNHCR experience? Yes No UNHCR MSRP ID
Contract Type Fixed Term Indefinite Temporary Appointment Other Arrangement
If ‘Other Arrangement’ please indicate the Type of Arrangement
(e.g. UN Volunteer, UNOPS ICA, Individual Consultant, Intern, ICMC, Danish Refugee Council etc.)
Print Date: 19 April 2018 Page 5 of 8
9. SPECIALIZED TRAINING (if any)
Course Title
School Name
Country
Course Start Date
(dd/mm/yyyy)
End Date
(dd/mm/yyyy)
Topic area
Training Methodology Assessment Blended Learning Programme Mobile Resource Material
Webinar Webinar for Blended Learning Workshop
Workshop for Blended Learning Training Video eLearning
Course Description
Course Title
School Name
Country
Course Start Date
(dd/mm/yyyy)
End Date
(dd/mm/yyyy)
Topic area
Training Methodology Assessment Blended Learning Programme Mobile Resource Material
Webinar Webinar for Blended Learning Workshop
Workshop for Blended Learning Training Video eLearning
Course Description
10. EDUCATION (Mandatory to complete even if you have no formal education; if so, please indicate)
This space provides you with an opportunity to indicate that your academic credential or degree was obtained from an
educational institution that is recognised or sanctioned by a competent national authority, included in the IAU/UNESCO list.
When evaluating academic credentials of applicants, UNHCR is guided by the United Nations Educational, Scientific and
Cultural Organization's (UNESCO) listing (referred to as the "UNESCO list - World Guide to Higher Education (WHED)" ) of
higher education institutions recognized, and to determine the level of university degree conferred on candidates since the
level of degrees is not always consistent across countries.
Please CHECK THE SITE TO CONFIRM YOUR UNIVERSITY IS ACCREDITED. (website - www.whed.net)
Note: You must indicate the main language used for 75% or more of your studies, for each education item you list.
Exact Title of
Degree/Certificate
Begin Date (dd/mm/yyyy) End Date (dd/mm/yyyy)
Main Major or Topic
Other Majors/Topics of
Study
Level
Elementary School Completed Some High School High School Graduate
Bachelor Masters Degree No Formal Education
Other (please specify in Comments)
Main language of your
studies
Education Completed? Yes No
School Name
City Country
Comments
Exact Title of
Degree/Certificate
Begin Date (dd/mm/yyyy) End Date (dd/mm/yyyy)
Print Date: 19 April 2018 Page 6 of 8
Main Major or Topic
Other Majors/Topics of
Study
Level
Elementary School Completed Some High School High School Graduate
Bachelor Masters Degree No Formal Education
Other (please specify in Comments)
Main language of your
studies
Education Completed? Yes No
School Name
City Country
Comments
11. SKILLS (if any) List skills such as computer or technical programs, or other relevant functional ability.
Level
(Low, Medium,
or High)
# of Yrs Comments
Skill
Skill
Skill
Skill
12. LANGUAGES (Mandatory to complete)
Indicate your proficiency levels for each language, including for your
Mother Tongue.
Proficiency levels are listed from A1 to C2, and are based on the Common
European Framework of Reference for Languages; the website is below.
https://www.eui.eu/Documents/ServicesAdmin/LanguageCentre/CEF.pdf
A1 (beginner)
B1 (pre-intermediate)
C1 (advanced)
A2 (basic)
B2 (intermediate)
C2 (proficient)
Reading Speaking Writing Listening
Mother Tongue Language
2nd
Language (if any)
(if applicable) Evaluation
Date (dd/mm/yyyy)
3rd
Language (if any)
(if applicable) Evaluation
Date (dd/mm/yyyy)
4th
Language (if any)
(if applicable) Evaluation
Date (dd/mm/yyyy)
13. LICENSES AND CERTIFICATIONS (if any)
Issue Date (dd/mm/yyyy) Expiration Date
(dd/mm/yyyy)
Licence /Certification
City Country
Is a renewal in progress? Yes No Licence /Certification
Number
Issued By
Issue Date (dd/mm/yyyy) Expiration Date
(dd/mm/yyyy)
Licence /Certification
City Country
Is a renewal in progress? Yes No Licence /Certification
Number
Issued By
Print Date: 19 April 2018 Page 7 of 8
14. THREE PROFESSIONAL REFERENCES (Mandatory to complete)
A Professional reference is a recommendation from a person who can vouch for your qualifications for a job.
This should not be the same person you listed as your supervisor for any of your work experiences.
Reference #1 - Name
Title
Employer
Phone Country Code Telephone # Ext.
Email Address
Address line 1
Address line 2
Address line 3 Postal Code
City Country
Reference #2 - Name
Title
Employer
Phone Country Code Telephone # Ext.
Email Address
Address line 1
Address line 2
Address line 3 Postal Code
City Country
Reference #3 - Name
Title
Employer
Phone Country Code Telephone # Ext.
Email Address
Address line 1
Address line 2
Address line 3 Postal Code
City Country
15. QUESTIONNAIRE (Mandatory to complete)
1. Are you now, or have you ever been, a permanent civil servant in your government's employ? If the answer is yes,
please provide the dates below.
Yes No
From Date
(dd/mm/yyyy)
To Date
(dd/mm/yyyy)
2. Have you ever been arrested, indicted or summoned in court as a defendant in a criminal proceeding, or convicted,
fined or imprisoned for the violation of any law (excluding minor traffic violations)? If the answer is yes, please provide
details below.
Details
Yes No
3. Have you ever been the subject of an investigation into allegations of misconduct?
Yes No
4. Have you ever been subject to disciplinary proceedings or measures?
Yes No
5. Would you accept employment for less than six months?
Yes No
6. Entry in United Nations service might require assignment to any area of the world in which United Nations might have
responsibilities. Are there any limitations on your ability to engage in your prospective field of work? If yes, please add
details below.
Details
Yes No
Print Date: 19 April 2018 Page 8 of 8
7. Entry in United Nations service might require assignment to any area of the world in which the United Nations might
have responsibilities. Are there any limitations on your engage in all travel? If yes, please add details below.
Details
Yes No
8. Working with UNHCR requires field work in difficult, high-risk, and non-family locations. Do you commit to accepting a
deployment to such field operations?
Yes No
9. Do you have a spouse or any children? If yes, please provide below the names, dates of birth and the relationships.
Yes No
Name Birth Date (dd/mm/yyyy) Relationship
10. Have you taken up legal permanent residence status in any country other than that of your nationality?
If the answer is yes, please indicate the country.
Yes No Country
11. State any other relevant facts. Include information regarding any residence outside the country of your nationality.
Details
Yes No
12. Have you taken any legal steps towards changing your present nationality?
If the answer is yes, please add details below.
Details
Yes No
13. Are any of your relatives, or is your spouse employed by a UN organization or Specialized Agency? If the answer is
yes, please indicate Name, Relationship, and Name of International Organization.
Yes No
Name Relationship Name of International Organization
14. How did you hear about this vacancy?
UNHCR Career Website Campus Presentation by UNHCR Career Information Visit by UNHCR
Other UN Website Government Agency Social Media (LinkedIn, Twitter, etc.) Job Fair
Print Media Job Board (UNJobFinder, WhereWomenWork, ReliefWeb, Devex, Monster, etc.)
Professional Association Referral by a friend Other
CONFIRMATION AND CONSENT (Mandatory to complete)
To complete your application you are required to confirm the following:
ACCURACY OF CONTENT: The content of this application is accurate and contains no false information;
EDUCATION INFORMATION - You give your full consent and authorize the Office of the United Nations High Commissioner
for Refugees (UNHCR) to contact each of your educational institutions listed in this application for the purpose of conducting
required reference checks with regard to your educational background, and to confirm the diploma or degrees you have
received at each educational institution.
You also authorize the mentioned educational institutions to provide requested information directly to UNHCR. Any information
received from your educational institutions will be treated with due regard to all confidentiality requirements; and,
WORK EXPERIENCE - You are aware UNHCR will contact former and current employers, if applicable, regarding Work
Experience, as well as check your three Professional References.
Finally, you understand that submission of false information or misrepresentation and/or submission of falsified
documentation constitutes serious misconduct for which severe disciplinary sanctions can be imposed.
I consent to all of the foregoing as part of the process of evaluation of my application.
DATE : _______________________ SIGNATURE: _____________________________

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Formato P11 ACNUR

  • 1. Print Date: 19 April 2018 Page 1 of 8 Personal History Form This form allows you to apply or express interest for Field positions in the General Service and National Professional categories, for Temporary Appointments in the Professional category, or for working under one of the affiliate schemes (UNOPS, Individual consultant or contractor, deployee, secondee, etc.). Please complete the form carefully, answering all mandatory sections fully and as completely as possible. Your Personal History Form will be reviewed in the near future, and you will be contacted if you are short-listed for an interview. Note: Please do not contact UNHCR directly regarding the status of this application. If you need assistance in completing this form, please contact UNHCR via the email address provided in the vacancy notice or liaise with your nearest UNHCR Office. 1. GENERAL INFORMATION (Mandatory to complete) Last Name Middle Name Maiden Name First Name 2. PERSONAL INFORMATION (Mandatory to complete) Date of Birth (dd/mm/yyyy) Gender Male Female No Selection Marital Status Married Single Divorced Common Law Registered Partnership Separated Widowed 3. CONTACT INFORMATION (Mandatory to complete) Current Address Address City Postal Code Country Permanent Address Address City Postal Code Country Preferred Contact Method Email Phone Post Mail 4. PHONE NUMBERS (Mandatory to complete) Type Country Code Telephone # Ext. Indicate which is Preferred Home Business Mobile 5. EMAIL ADDRESSES (Mandatory to complete) Type Email Address Indicate which is Preferred Home Business 6. NATIONALITY INFORMATION (Mandatory to complete) NATIONALITY INFORMATION Please list all COUNTRIES as applicable Nationalities at Birth Current Nationalities Permanent Residency
  • 2. Print Date: 19 April 2018 Page 2 of 8 7. LETTER OF INTEREST (Mandatory to complete if applying for a specific vacancy announcement) Please indicate the position you are applying for Please answer the following questions. 1. How have your achievements and operational experience to date prepared you for this position? Please refer to the job description and to the essential requirements therein. (1500 characters max) 2. Please describe any skills and competencies you have, and which may be of particular relevance to this position. (1500 characters max) 3. How does this position align with your career aspirations? (1000 characters max)
  • 3. Print Date: 19 April 2018 Page 3 of 8 8. WORK EXPERIENCE (Mandatory to complete, if any) For all work experience, please complete as much information as possible. Starting with your present position, list in REVERSE ORDER all employment you have had, using a separate block for each work experience. Also include service in the armed forces. Note any period during which you were not gainfully employed. Three blocks are provided; if you need more space, attach additional pages ensuring to give the same information requested here. Start Date (dd/mm/yyyy) End Date (dd/mm/yyyy) Full Part-Time Employer Check if ongoing Job Title Supervisor Name Type of Employment Employee Consultant Intern Self-employed UN Volunteer Volunteer Other If ‘Other’ please explain Type of Workers Supervised # of Persons Supervised Supervisor e-mail Supervisor Phone Ending Pay Rate Amount (Annual Net) Currency Reason for Leaving Description of duties (1200 characters max) Employer Address line 1 Address line 2 Address line 3 Postal Code City Country Type of Business Governmental Organization International Organization Non-Governmental Organization Private Sector Other Is this UN Experience? Yes No Grade (if applicable) UN Index # Is this UNHCR experience? Yes No UNHCR MSRP ID Contract Type Fixed Term Indefinite Temporary Appointment Other Arrangement If ‘Other Arrangement’ please indicate the Type of Arrangement (e.g. UN Volunteer, UNOPS ICA, Individual Consultant, Intern, ICMC, Danish Refugee Council etc.) Start Date (dd/mm/yyyy) End Date (dd/mm/yyyy) Full Part-Time Employer Check if ongoing Job Title Supervisor Name Type of Employment Employee Consultant Intern Self-employed UN Volunteer Volunteer Other If ‘Other’ please explain Type of Workers Supervised # of Persons Supervised Supervisor e-mail Supervisor Phone Ending Pay Rate Amount (Annual Net) Currency Reason for Leaving
  • 4. Print Date: 19 April 2018 Page 4 of 8 Description of duties (1200 characters max) Employer Address line 1 Address line 2 Address line 3 Postal Code City Country Type of Business Governmental Organization International Organization Non-Governmental Organization Private Sector Other Is this UN Experience? Yes No Grade (if applicable) UN Index # Is this UNHCR experience? Yes No UNHCR MSRP ID Contract Type Fixed Term Indefinite Temporary Appointment Other Arrangement If ‘Other Arrangement’ please indicate the Type of Arrangement (e.g. UN Volunteer, UNOPS ICA, Individual Consultant, Intern, ICMC, Danish Refugee Council etc.) Start Date (dd/mm/yyyy) End Date (dd/mm/yyyy) Full Part-Time Employer Check if ongoing Job Title Supervisor Name Type of Employment Employee Consultant Intern Self-employed UN Volunteer Volunteer Other If ‘Other’ please explain Type of Workers Supervised # of Persons Supervised Supervisor e-mail Supervisor Phone Ending Pay Rate Amount (Annual Net) Currency Reason for Leaving Description of duties (1200 characters max) Employer Address line 1 Address line 2 Address line 3 Postal Code City Country Type of Business Governmental Organization International Organization Non-Governmental Organization Private Sector Other Is this UN Experience? Yes No Grade (if applicable) UN Index # Is this UNHCR experience? Yes No UNHCR MSRP ID Contract Type Fixed Term Indefinite Temporary Appointment Other Arrangement If ‘Other Arrangement’ please indicate the Type of Arrangement (e.g. UN Volunteer, UNOPS ICA, Individual Consultant, Intern, ICMC, Danish Refugee Council etc.)
  • 5. Print Date: 19 April 2018 Page 5 of 8 9. SPECIALIZED TRAINING (if any) Course Title School Name Country Course Start Date (dd/mm/yyyy) End Date (dd/mm/yyyy) Topic area Training Methodology Assessment Blended Learning Programme Mobile Resource Material Webinar Webinar for Blended Learning Workshop Workshop for Blended Learning Training Video eLearning Course Description Course Title School Name Country Course Start Date (dd/mm/yyyy) End Date (dd/mm/yyyy) Topic area Training Methodology Assessment Blended Learning Programme Mobile Resource Material Webinar Webinar for Blended Learning Workshop Workshop for Blended Learning Training Video eLearning Course Description 10. EDUCATION (Mandatory to complete even if you have no formal education; if so, please indicate) This space provides you with an opportunity to indicate that your academic credential or degree was obtained from an educational institution that is recognised or sanctioned by a competent national authority, included in the IAU/UNESCO list. When evaluating academic credentials of applicants, UNHCR is guided by the United Nations Educational, Scientific and Cultural Organization's (UNESCO) listing (referred to as the "UNESCO list - World Guide to Higher Education (WHED)" ) of higher education institutions recognized, and to determine the level of university degree conferred on candidates since the level of degrees is not always consistent across countries. Please CHECK THE SITE TO CONFIRM YOUR UNIVERSITY IS ACCREDITED. (website - www.whed.net) Note: You must indicate the main language used for 75% or more of your studies, for each education item you list. Exact Title of Degree/Certificate Begin Date (dd/mm/yyyy) End Date (dd/mm/yyyy) Main Major or Topic Other Majors/Topics of Study Level Elementary School Completed Some High School High School Graduate Bachelor Masters Degree No Formal Education Other (please specify in Comments) Main language of your studies Education Completed? Yes No School Name City Country Comments Exact Title of Degree/Certificate Begin Date (dd/mm/yyyy) End Date (dd/mm/yyyy)
  • 6. Print Date: 19 April 2018 Page 6 of 8 Main Major or Topic Other Majors/Topics of Study Level Elementary School Completed Some High School High School Graduate Bachelor Masters Degree No Formal Education Other (please specify in Comments) Main language of your studies Education Completed? Yes No School Name City Country Comments 11. SKILLS (if any) List skills such as computer or technical programs, or other relevant functional ability. Level (Low, Medium, or High) # of Yrs Comments Skill Skill Skill Skill 12. LANGUAGES (Mandatory to complete) Indicate your proficiency levels for each language, including for your Mother Tongue. Proficiency levels are listed from A1 to C2, and are based on the Common European Framework of Reference for Languages; the website is below. https://www.eui.eu/Documents/ServicesAdmin/LanguageCentre/CEF.pdf A1 (beginner) B1 (pre-intermediate) C1 (advanced) A2 (basic) B2 (intermediate) C2 (proficient) Reading Speaking Writing Listening Mother Tongue Language 2nd Language (if any) (if applicable) Evaluation Date (dd/mm/yyyy) 3rd Language (if any) (if applicable) Evaluation Date (dd/mm/yyyy) 4th Language (if any) (if applicable) Evaluation Date (dd/mm/yyyy) 13. LICENSES AND CERTIFICATIONS (if any) Issue Date (dd/mm/yyyy) Expiration Date (dd/mm/yyyy) Licence /Certification City Country Is a renewal in progress? Yes No Licence /Certification Number Issued By Issue Date (dd/mm/yyyy) Expiration Date (dd/mm/yyyy) Licence /Certification City Country Is a renewal in progress? Yes No Licence /Certification Number Issued By
  • 7. Print Date: 19 April 2018 Page 7 of 8 14. THREE PROFESSIONAL REFERENCES (Mandatory to complete) A Professional reference is a recommendation from a person who can vouch for your qualifications for a job. This should not be the same person you listed as your supervisor for any of your work experiences. Reference #1 - Name Title Employer Phone Country Code Telephone # Ext. Email Address Address line 1 Address line 2 Address line 3 Postal Code City Country Reference #2 - Name Title Employer Phone Country Code Telephone # Ext. Email Address Address line 1 Address line 2 Address line 3 Postal Code City Country Reference #3 - Name Title Employer Phone Country Code Telephone # Ext. Email Address Address line 1 Address line 2 Address line 3 Postal Code City Country 15. QUESTIONNAIRE (Mandatory to complete) 1. Are you now, or have you ever been, a permanent civil servant in your government's employ? If the answer is yes, please provide the dates below. Yes No From Date (dd/mm/yyyy) To Date (dd/mm/yyyy) 2. Have you ever been arrested, indicted or summoned in court as a defendant in a criminal proceeding, or convicted, fined or imprisoned for the violation of any law (excluding minor traffic violations)? If the answer is yes, please provide details below. Details Yes No 3. Have you ever been the subject of an investigation into allegations of misconduct? Yes No 4. Have you ever been subject to disciplinary proceedings or measures? Yes No 5. Would you accept employment for less than six months? Yes No 6. Entry in United Nations service might require assignment to any area of the world in which United Nations might have responsibilities. Are there any limitations on your ability to engage in your prospective field of work? If yes, please add details below. Details Yes No
  • 8. Print Date: 19 April 2018 Page 8 of 8 7. Entry in United Nations service might require assignment to any area of the world in which the United Nations might have responsibilities. Are there any limitations on your engage in all travel? If yes, please add details below. Details Yes No 8. Working with UNHCR requires field work in difficult, high-risk, and non-family locations. Do you commit to accepting a deployment to such field operations? Yes No 9. Do you have a spouse or any children? If yes, please provide below the names, dates of birth and the relationships. Yes No Name Birth Date (dd/mm/yyyy) Relationship 10. Have you taken up legal permanent residence status in any country other than that of your nationality? If the answer is yes, please indicate the country. Yes No Country 11. State any other relevant facts. Include information regarding any residence outside the country of your nationality. Details Yes No 12. Have you taken any legal steps towards changing your present nationality? If the answer is yes, please add details below. Details Yes No 13. Are any of your relatives, or is your spouse employed by a UN organization or Specialized Agency? If the answer is yes, please indicate Name, Relationship, and Name of International Organization. Yes No Name Relationship Name of International Organization 14. How did you hear about this vacancy? UNHCR Career Website Campus Presentation by UNHCR Career Information Visit by UNHCR Other UN Website Government Agency Social Media (LinkedIn, Twitter, etc.) Job Fair Print Media Job Board (UNJobFinder, WhereWomenWork, ReliefWeb, Devex, Monster, etc.) Professional Association Referral by a friend Other CONFIRMATION AND CONSENT (Mandatory to complete) To complete your application you are required to confirm the following: ACCURACY OF CONTENT: The content of this application is accurate and contains no false information; EDUCATION INFORMATION - You give your full consent and authorize the Office of the United Nations High Commissioner for Refugees (UNHCR) to contact each of your educational institutions listed in this application for the purpose of conducting required reference checks with regard to your educational background, and to confirm the diploma or degrees you have received at each educational institution. You also authorize the mentioned educational institutions to provide requested information directly to UNHCR. Any information received from your educational institutions will be treated with due regard to all confidentiality requirements; and, WORK EXPERIENCE - You are aware UNHCR will contact former and current employers, if applicable, regarding Work Experience, as well as check your three Professional References. Finally, you understand that submission of false information or misrepresentation and/or submission of falsified documentation constitutes serious misconduct for which severe disciplinary sanctions can be imposed. I consent to all of the foregoing as part of the process of evaluation of my application. DATE : _______________________ SIGNATURE: _____________________________