|P.11 (2-74) - E |
| | |Do Not Write in This Space |
|INSTRUCTIONS | | |
|Please answer each question clearly |UNITED [pic] NATIONS | |
|and completely. Type or print in ink.| | |
|Read carefully and follow all |PERSONAL HISTORY | |
|directions. | | |
|1. Family name |First name |Middle name |Maiden name, if any |
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|MINOO |CHRIS |NATHAN | |
|2. Date |Day |Mo. |Yr. |3. Place of birth |4. Nationality (ies) at birth |5. Present nationality (ies) |6. Sex |
|of |22 |02 |94 |GEORGETOWN PUBLIC HOSPITAL |GUYANESE |GUYANESE |M |
|Birth | | | | | | | |
|7. Height |8. Weight |9. Marital status: | | | | |
|165CM |145 |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. |
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|11. Permanent address |12. Present address (if different) |13. Office Telephone No. |
| | | Office Fax. No |
|123 GARNETT STREET NEWTOWN KITTY | |E-mail: chrisminoo@yahoo.com |
| Telephone No. |227-6694 | Telephone/Fax No. | | |
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|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 |
|ROBERT MINOO |24/02/1959 |FATHER | | | |
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|16. Have you taken up legal permanent residence status in any country other than that of your nationality? |YES NO |
|If answer is “yes”, which country? | |
|17. Have you taken any legal steps towards changing your present nationality? |YES NO | |
|If answer is “yes”, explain fully: | | |
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|18. Are any of your relatives employed by a public international organization? | YES NO |
|If answer is “yes”, give the following information: | |
|NAME |Relationship |Name of International Organization |
|NESSA THOMAS |COUSIN |GEORGETOWN PUBLIC HOSPITAL |
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|19. What is your preferred field of work? |MEDICAL FIELD |
|20. Would you accept employment for less |21. Have you previously submitted an application for employment with U.N.? |
| than six months |YES NO | if so when? |NOT APPLICABLE |
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|22. KNOWLEDGE OF LANGUAGES. What is your mother tongue? ENGLISH |
| |READ |WRITE |SPEAK |UNDERSTAND |
| | |Not | |Not | |Not | |Not |
|OTHER LANGUAGES |Easily |Easily |Easily |Easily |Easily |Easily |Easily |Easily |
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|23. For clerical grades only |List any office machines or equipment |
|Indicate speed in words per minute |you can use |
| | | |O t h e r l a n g u a g e s | |
| |E n g l i s h |F r e n c h | | | |
|Typing | | | | | |
|Shorthand | | | | | |
|24. EDUCATIONAL. Give full details - N.B. Please give exact titles of degrees in original language. |
|A. UNIVERSITY OR EQUIVALENT Please do not translate or equate to other degrees. |
| |ATTENDED FROM/TO |DEGREES and ACADEMIC | |
|NAME, PLACE AND COUNTRY | | |MAIN COURSE OF STUDY |
| |Mo./Year |Mo./Year |DISTINCTIONS OBTAINED | |
|TEXILA AMERICAN UNIVERSITY, GEORGETOWN GUYANA. |06/2011 |03/2013 |NOT COMPLETED |MEDICINE |
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|B. SCHOOLS OR OTHER FORMAL TRAINING OR EDUCATION FROM AGE 14 (e.g. high school, technical school or apprenticeship) |
| | |ATTEND FROM/TO |CERTIFICATES OR |
|NAME, PLACE AND COUNTRY |TYPE | | |
| | |Mo./Year |Mo./Year |DIPLOMAS OBTAINED |
|NORTH GEORGETOWN SECONDARY |HIGH SCOOL |09/2005 |06/2010 |CSEC GENERAL PROFECENCY CERTIFICATE |
|GLOBAL TECHNOLOGY |COMPUTER COURSE |07/2006 |08/2006 |CERTIFACATE IN MICROSOFT WORD AND MICROSOFT |
| | | | |EXCEL 2003/2007 |
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|25. LIST PROFESSIONAL SOCIETIES AND ACTIVITIES IN CIVIC, PUBLIC OR INTERNATIONAL AFFAIRS |
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|SECRETARY/TREASURER OF NATIONAL YOUTH COUNCIL OF GUYANA PRESBYTARIAN CHURCH (2013-2014) |
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|26. LIST ANY SIGNIFICANT PUBLICATIONS YOU HAVE WRITTEN (do not attach) |
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|27. |EMPLOYMENT RECORD: Starting with your present post, list in reverse order every employment you have had. Use a separate block for each post. 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. Give both gross and net salaries per annum for your last or present post. |
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| |A. PRESENT POST (LAST POST, IF NOT PRESENTLY IN EMPLOYMENT) |
|FROM |TO |SALARIES PER ANNUM |EXACT TITLE OF YOUR POST: |
|MONTH/YEAR |MONTH/YEAR |STARTING |FINAL | |
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|NAME OF EMPLOYER: |TYPE OF BUSINESS: |
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|ADDRESS OF EMPLOYER: |NAME OF SUPERVISOR: |
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| |NO. AND KIND OF EMPLOYEES |REASON FOR LEAVING: |
| |SUPERVISED BY YOU: | | |
|DESCRIPTION OF YOUR DUTIES |
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|B. PREVIOUS POSTS (IN REVERSE ORDER) |
|FROM |TO |SALARIES PER ANNUM |EXACT TITLE OF YOUR POST: |
|MONTH/YEAR |MONTH/YEAR |STARTING |FINAL | |
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|NAME OF EMPLOYER: |TYPE OF BUSINESS: |
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|ADDRESS OF EMPLOYER: |NAME OF SUPERVISOR: |
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| |NO. AND KIND OF EMPLOYEES |REASON FOR LEAVING: |
| |SUPERVISED BY YOU: | |
|DESCRIPTION OF YOUR DUTIES |
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|FROM |TO |SALARIES PER ANNUM |EXACT TITLE OF YOUR POST: |
|MONTH/YEAR |MONTH/YEAR |STARTING |FINAL | |
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|NAME OF EMPLOYER: |TYPE OF BUSINESS: |
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|ADDRESS OF EMPLOYER: |NAME OF SUPERVISOR: |
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| |NO. AND KIND OF EMPLOYEES |REASON FOR LEAVING |
| |SUPERVISED BY YOU: | |
|DESCRIPTION OF YOUR DUTIES |
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|FROM |TO |SALARIES PER ANNUM |EXACT TITLE OF YOUR POST: |
|MONTH/YEAR |MONTH/YEAR |STARTING |FINAL | |
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|NAME OF EMPLOYER: |TYPE OF BUSINESS: |
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|ADDRESS OF EMPLOYER: |NAME OF SUPERVISOR: |
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| |NO. AND KIND OF EMPLOYEES |REASON FOR LEAVING |
| |SUPERVISED BY YOU: | |
|DESCRIPTION OF YOUR DUTIES |
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|FROM |TO |SALARIES PER ANNUM |EXACT TITLE OF YOUR POST: |
|MONTH/YEAR |MONTH/YEAR |STARTING |FINAL | |
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|NAME OF EMPLOYER: |TYPE OF BUSINESS: |
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|ADDRESS OF EMPLOYER: |NAME OF SUPERVISOR: |
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| |NO. AND KIND OF EMPLOYEES |REASON FOR LEAVING |
| |SUPERVISED BY YOU: | |
|DESCRIPTION OF YOUR DUTIES |
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|28. HAVE YOU ANY OBJECTIONS TO OUR MAKING INQUIRIES OF YOUR PRESENT EMPLOYER? YES NO |
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|29. ARE YOU NOW, OR HAVE TO EVER BEEN, A PERMANENT CIVIL SERVANT IN YOUR GOVERNMENT’S EMPLOY? YES NO |
| If answer is “yes”, WHEN? |
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|30. REFERENCES: List three persons, not related to you, who are familiar with your character and qualifications. |
|Do not repeat names of supervisors listed under item 27. |
|FULL NAME |FULL ADDRESS |BUSINESS OR OCCUPATION |
|IAN JACK |141 REGENT STREET BOURDA |BUSINESS PROPRIETOR |
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|31. STATE ANY OTHER RELEVANT FACTS, INCLUDING INFORMATION REGARDING ANY RESIDENCE OUTSIDE THE COUNTRY OF YOUR NATIONALITY |
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| NONE |
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|32.. |HAVE YOUR EVER BEEN ARRESTED, INDICTED, OR SUMMONED INTO COURT AS A DEFENDANT IN A CRIMINAL PROCEEDING, OR CONVICTED, FINED OR IMPRISONED FOR THE VIOLATION|
| |OF ANY LAW (excluding minor traffic violations)? YES NO |
| |If “yes”, give full particulars of each case in an attached statement. |
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|33. |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 a Personal History form or other document requested by the Organization renders a staff |
| |member of the United Nations liable to termination or dismissal. |
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| |DATE: |3RD MARCH, 2014 | |SIGNATURE : |C. MINOO |
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|N.B. |You will be requested to supply documentary evidence which supports the statements you have made above. Do not, however, send any documentary evidence |
| |until you have been asked to do so by the Organization and, in any event, do not submit the original texts of references or testimonials unless they have|
| |been obtained for the sole use of the Organization. |
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