EXP/CONF	
	INTERNATIONAL  TELECOMMUNICATION  UNION		PROJECT  PERSONNEL	

Attach
recent
photograph
here	Information given should be clear, concise and accurate. DO NOT USE ABBREVIATIONS – their significance may not be known on a world-wide basis.
If your candidature is being considered for an ITU expert post, a photocopy of EXP/1 (but not EXP/CONF) may be sent to the requesting Government, which latter makes the final selection. PLEASE THEREFORE COMPLETE THIS FORM IN TYPESCRIPT (or failing that print clearly in black ink) to facilitate reproduction.
PLEASE CONFINE THE DESCRIPTION OF YOUR QUALIFICATIONS/EXPERIENCE TO THE FOUR PAGES OF EXP/1 (only publications may be listed on a supplementary sheet if the space allotted is insufficient).	
	LANGUAGE:	If you are applying for a post stipulating English, French or Spanish as ESSENTIAL, please complete the appropriate form in the required language. Bilingual or trilingual candidates will complete a set of this form in each language.	
	CONFIDENTIAL  –  FOR  USE  EXCLUSIVELY  AT  ITU  HEADQUARTERS	
1	Family name (surname)	First/other names	Mr/Mrs/Miss

     	     	     	Maiden name if any

     	
	Present nationality	Date	Day	Month	Year	Place and country of birth	
		of birth					
	     		     	     	     				     	
	Passport
details	No.
     	Place and date of issue
     	Date of expiry
     	
	Has your nationality ever been changed or is it in the process of being changed?	   No          Yes (explain)       
     	
	Private address
     	
Tel:	     
Fax: 	     	
MARITAL  STATUS	
	Permanent address (if different from above)
     	
Tel: 	     
Fax: 	     	   single
   married
   widow(er)	
	Professional address
     	
Tel: 	     
Fax: 	     	   separated
   divorced)	

2	What do you consider as your specialization?
	     	If you apply for a vacancy announcement state number
or reference
     	
  	Would you accept employment for                      less than six months?                        one year?                     more than one year?  		
	If you were offered a post, how soon
could you report for duty?	     	
	Employment by the ITU may require assignment and travel to any area. Please indicate if for medical or any other reasons you are prevented from travelling.
     		

3	Positions	ANNUAL  SALARY
GROSS and NET  (i.e. after  tax)	ALLOWANCES
in addition to salary	SUPERVISOR’S
NAME  AND  TITLE	
			Initial	Final			Dates	
	Present	Gross		     		     		     	     	From	     	
	post	Net		     		     		     	     	To	     	
	Preceding	Gross		     		     		     	     	From	     	
	post	Net		     		     		     	     	To	     	

4	Give names of spouse and any dependents.		
	Name	Date of Birth	Relationship	Name	Date of Birth	Relationship		
	     	     	     	     	     	     		
	     	     	     	     	     	     		
	     	     	     	     	     	     		
	     	     	     	     	     	     		
	Give details of any near relatives who are employed by the United Nations or one of its Specialized Agencies.		
	Name	Relationship	International Organization	
	     	     	     	
	     	     	     	

5	If you have ever been found guilty of the violation of any law (except minor traffic violations) give full particulars.	
     	

6	REFERENCES	List three persons not related to you who are familiar with your character and qualifications.
	Do not repeat names of supervisors listed under point 3 above.	
	Name	Full address	Telephone No.	Occupation, business, title	
	     	     	Office
	     
Home
	     	     	
	     	     	Office
	     
Home
	     	     	
	     	     	Office
	     
Home
	     	     	

7	Preference as to countries/regions in which you would wish to serve; other comments.
     	

8	I certify that the statements made by me on this form are true, complete and correct.
I understand that any false statement or required information withheld may provide grounds for the withdrawal of any offer of appointment or the cancellation of any contract of employment with the ITU.

Date and place:  	     	Signature:  	     

	INTERNATIONAL  TELECOMMUNICATION  UNION		PERSONAL  HISTORY  STATEMENT	EXP/1	

PROJECT   PERSONNEL
For  submission  to  Governments

1	Name       
Present address       	Nationality       

Place and date of birth       	

2	LANGUAGE  KNOWLEDGE	OTHER  LANGUAGES	Speak	Read	Write	
	MOTHER  TONGUE  	     
For  other languages, enter appropriate number from code below
to indicate level of your language knowledge.
    CODE :	1.	Limited conversation, reading of newspapers,
routine correspondence.
	2.	Engage freely in discussions, read and write
more difficult material.
	3.	Speak, read and write (nearly) as well as
mother  tongue.	     
	
     
	
     
	
     
	
     

	

			

		

3	EDUCATION	Give full details in chronological order. Give the exact name of the institution and title of degrees/certificates in the original language. Exclude primary/secondary school if you have a university degree or equivalent. Include courses and post-graduate studies in your professional or related field.	
	From
Month/year	To
Month/year	Institution (name, place)	Certificates,
degrees obtained	Main (field(s) or subject(s) of study	
	     	     	     	     	     	
	     	     	     	     	     	
	     	     	     	     	     	
	     	     	     	     	     	
	     	     	     	     	     	
	     	     	     	     	     	
	     	     	     	     	     	
	     	     	     	     	     	
	     	     	     	     	     	

4	List titles of significant publications or papers in you professional field which you have written, as also names of journals, etc., in which they appeared (use supplementary sheet if necessary).  DO  NOT  ATTACH  PUBLICATIONS.
     	

5	List Professional Societies of which you are a member; indicate the class of membership when appropriate.
     	

N.B.:	IN  COMPLETING  SECTION  6  HEREUNDER,  PLEASE  COMMENCE  BY  COMPLETING  POINT  E  (next page)  FOLLOWED
BY  D,  C,  B  and  A  IN  THAT  ORDER  AS  APPLICABLE.
6	PROFESSIONAL  EXPERIENCE	
A	Summary of employment record in  CHRONOLOGICAL  ORDER  (excepting four most recent posts).	
	     	

B	From       	To       
	Name and address of employer
     	
Exact title of your post       
     
     
	Number and type of employees supervised by you, if any
     	
	Description of your duties and responsibilities
     	

C	From       	To       
	Name and address of employer
     	
Exact title of your post       
     
     
	Number and type of employees supervised by you, if any
     	
	Description of your duties and responsibilities
     	
D	From       	To       
	Name and address of employer
     	
Exact title of your post       
     
     
	Number and type of employees supervised by you, if any
     	
	Description of your duties and responsibilities
     	

E	PRESENT  OR  MOST  RECENT  EMPLOYMENT
	From       	To       
	Name and address of employer
     	
Exact title of your post       
     
     
	Number and type of employees supervised by you, if any
     	
	Description of your duties and responsibilities
     	
F	DO  NOT  FILL  IN  –  INTENDED  FOR  FUTURE  ADDITIONS
	From       	To       
	Name and address of employer
     	
Exact title of your post       
     
     
	Number and type of employees supervised by you, if any
     	
	Description of your duties and responsibilities
     	
	Date of updating:        	

7	List type/makes of equipment on which you have:  A) worked;  B) received training.
     	

8	Additional Information relevant to your work and the post for which you are applying (i.e. experience in on-the-job training
or modern training
     	
	Date:  	     	Signature: