Personal History Form

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INTERNATIONAL ORGANIZATION FOR MIGRATION

17, Route des Morillons


P.O. Box 71
If you are applying for a specific CH - 1211 GENEVA 19
Vacancy Notice, please quote SWITZERLAND
relevant position title and vacancy
number:
Applications must be filed in one of
IOM's official languages (English, PERSONAL ATTACH
French or Spanish). Applications in PHOTOGRAPH
other languages may be rejected. HISTORY HERE
Make sure you complete all four
pages of the personal history form.

1. A) Surname First Name Middle Name Maiden Name, if any

B) List any other names used


2. A) Permanent Address B) Telephone No.

3. A) Present Residence (Specify City, Province or State, Country) B) Since (date) Until (anticipated date) C) Telephone No.

D) E-mail address (1) E) E-mail address (2), if applicable

4. A) Place of Birth B) Date of Birth C) Citizenship at Birth D) Present Citizenship


(If Swiss, canton and origin)

E) Passport or Identity Card No. Date of Issue/Date of Expiry Place of Issue (in full)

5. Sex (Check) 6. Marital Status (Check)

Male |__| Female |__| Single |___| Married |__| Widow(er) |__| Divorced |__ Separated |__|

7. Have you any depedents? Yes |___| No |___| If answer is "Yes" give following information:
Name Age Relationship Name Age Relationship

8. LANGUAGES
(List mother tongue first)
READ WRITE SPEAK
Language
Excellent Good Poor Excellent Good Poor Excellent Good Poor

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9. EDUCATION: Give full details, using the following space in so far as it is appropriate of schools or other formal training or education from age 14 (e.g. high
school, technical school, apprenticeship, university or its equivalent):
Years attended Certificates, diplomas, degrees or
Name and Place Type
From To academic distinctions obtained

B) List any special skills you possess and machines and


10. A) Indicate speed in words per minute (if applicable)
equipment you can use
Other Languages
English French Spanish
Shorthand
Typing
11. List all organizations with which you are or have been affiliated. This list is to include all affiliations, whether social, professional, fraternal, etc.

12. List activities in civic, public or international affairs and name any significant publications you have written.

13. For what kind of work do you wish to be considered?

14. A) Are you willing to accept a post requiring travel?

B) Would you accept short term employment?

C) Would you accept an emergency field assignment at short notice?

15. In the event of your being selected, how much notice would you need before appointment?

16. Have you any objections to our making inquiries of your present employer? Yes |___| No |___|
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17. EMPLOYMENT RECORD : Starting with your present occupation, list in reverse order each activity in which you have been engaged,accounting
fully for your time. List military service and any period of unemployment of more than six months' duration. Use a separate block for each period
and additional sheets if necessary.
Present or most recent occupation Description of duties and responsibilities
Dates Annual emoluments:
From To
Salary
(month/year) (month/year)

Allowances

Total
Business or organization (name and address, including city)

Title of your post or Name of Supervisor


occupation

Number and kind of employees supervised by you

Personal address during this period

Reason for leaving

Dates Total annual emoluments: Description of duties and responsibilities


From To
(month/year) (month/year)

Business or organization (name and address, including city)

Title of your post or Name of Supervisor


occupation

Number and kind of employees supervised by you

Personal address during this period

Reason for leaving

Dates Total annual emoluments: Description of duties and responsibilities


From To
(month/year) (month/year)

Business or organization (name and address, including city)

Title of your post or Name of Supervisor


occupation

Number and kind of employees supervised by you

Personal address during this period

Reason for leaving

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17. EMPLOYMENT RECORD : Starting with your present occupation, list in reverse order each activity in which you have been engaged,accounting
fully for your time. List military service and any period of unemployment of more than six months' duration. Use

Present or most recent occupation Description of duties and responsibilities


Dates Annual emoluments:
From To
Salary
(month/year) (month/year)

Allowances

Total
Business or organization (name and address, including city)

Title of your post or Name of Supervisor


occupation

Number and kind of employees supervised by you

Personal address during this period

Reason for leaving

Dates Total annual emoluments: Description of duties and responsibilities


From To
(month/year) (month/year)

Business or organization (name and address, including city)

Title of your post or Name of Supervisor


occupation

Number and kind of employees supervised by you

Personal address during this period

Reason for leaving

Dates Total annual emoluments: Description of duties and responsibilities


From To
(month/year) (month/year)

Business or organization (name and address, including city)

Title of your post or Name of Supervisor


occupation

Number and kind of employees supervised by you

Personal address during this period

Reason for leaving

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17. EMPLOYMENT RECORD : Starting with your present occupation, list in reverse order each activity in which you have been engaged,accounting
fully for your time. List military service and any period of unemployment of more than six months' duration. Use

Present or most recent occupation Description of duties and responsibilities


Dates Annual emoluments:
From To
Salary
(month/year) (month/year)

Allowances

Total
Business or organization (name and address, including city)

Title of your post or Name of Supervisor


occupation

Number and kind of employees supervised by you

Personal address during this period

Reason for leaving

Dates Total annual emoluments: Description of duties and responsibilities


From To
(month/year) (month/year)

Business or organization (name and address, including city)

Title of your post or Name of Supervisor


occupation

Number and kind of employees supervised by you

Personal address during this period

Reason for leaving

Dates Total annual emoluments: Description of duties and responsibilities


From To
(month/year) (month/year)

Business or organization (name and address, including city)

Title of your post or Name of Supervisor


occupation

Number and kind of employees supervised by you

Personal address during this period

Reason for leaving

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18. 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 17.
Name in full Complete Address (Telephone No. if known) Business or Occupation

19. (a) Have you ever been arrested, indicted or summoned into court as a defendant in a criminal proceeding, or convicted, fined or imprisoned or placed
on probation in connection with such a proceeding, or have you ever been arrested or required to deposit bail or collateral for the violation of any law or
regulation, civil or military (excluding traffic violations)?

Answer ''Yes'' or ''No''

(b) If your answer is ''Yes'' under item 19 (a) above, attach separate sheet giving details of all arrests and fines other than minor traffic violations. Specify
charge, date, place where arrested, and disposition.
20. State any other relevant facts. Include information regarding any residence or prolonged travel abroad, give dates, areas, purpose, etc. State any
significant experience not included in Section 17 which you believe will serve in the evaluation of your record.

21. State any disabilities which might limit the performance of your work.
(Appointment is subject to compliance with medical requirements.)

Having answered every question above, I, the undersigned, declare that the information contained in this form is, to the best of my knowledge, true,
complete and accurate, knowing that, if employed, any false declaration or concealment of material facts may result in disciplinary action including
dismissal.

Place and Date Signature

PLEASE NOTE

Applications will not, as a general rule, be valid or retained by the Organization for more than one year from date of receipt. While you may rest assured that
your candidature will be carefully examined, receipt of this form will not be acknowledged, and any further correspondence will be initiated by the
Organization.

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