| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | Applicant ID No. | | | | | | | | | | | | |
| |  | | | | | | | ASIAN DEVELOPMENT BANK | | | | | | | | | | | | | | | | | chedrb | | | |
| | | | | | | | | P.O. BOX 789, 0980 Manila | | | | | | | | | | | | | | | | | | | | |
| | | | | | | | | PHILIPPINES | | | | | | | | | | | | | | | | | To: | Celia R. Baltao/OAS/ADB@ADB | | |
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| | | | | | | | | Telephone (63-2) 632-4444 | | | | | | | | | | Fax (63-2) 636-2526; (63-2) 636-2444 | | | | | | | | | | | | | | | | | | |
| | | | | | | | | Website: http://www.adb.org | | | | | | | | | | E-mail Address: jobs@adb.org | | | | | | | | | | | | | Affix Recent | | | | | | | | Subject: | Unified Personal History Form -- Additional item | | |
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| | | | | | | | | PERSONAL HISTORY FORM | | | | | Passport Size Photo | | | | | | Ched: | | | |
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| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | Again, thank you for your suggestion. | | | |
| | . | Please type or print your answer to each question clearly and comletely. | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| | . | Read and follow carefully all the directions given. | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | Here are the following information for your incorporation in the final form. | | | |
| | . | Do not write in shaded areas. | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| | . | The maximum validity period for a Personal History Form is two(2) years from date of receipt. | | | | | | | | | | | | | | | | | | | | | | | | 1 | Website: | www.adb.org | |
| | . | Appointments to the staff of ADB will be valid only after you passed the prescribed medical examinations. | | | | | | | | | | | | | | | | | | | | | 2 | Emails: | | jobs@adb.org for Professional Staff and Young Professional applications |
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | ss-jobs@adb.org for Support Staff applications. |
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| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | Have a nice weekend. | | | |
| | 1. | Family Name (Last name) | | | | | | | | | | First Name | | | | | | | | | | | | | | | Middle Name | | | | | | | | | | | | | |
| | | | | | | | | | | | | | | Mary Anne | | | |
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| | 2. | Permanent Address (City/State/Country) | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | Telephone Numbers | | | | | | | | | | | |
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | Home | | | | | | | | | |
| | | | | | | | | | | | | | | | | | | | | | | Zip Code | | | | | | | | | Other | | | | | | | | | |
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| | 3. | Contact Address (City/State/Country) | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
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| | | | | | | | | | | | | | | | | | | | | | | Zip Code | | | | | | | | | E-mail | | | | | | | | | |
| | | Validity Dates for Contact: | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| | | | | | | | | | | | | | DD | MM | YYYY | | | | DD | MM | YYYY | | | | | | | | | | | | | | | | | | | | |
| | | | | | | | | | | | From | | | | | To | | | | | | | | | | | | | | | | | | | | | | | |
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| | 4. | Gender | | | | 5. | Height | | | | | 6. | Weight | | | | | 7. | Civil Status | | | | | | | | | | | | | | | | | | | | | | | | | |
| | | M | F | | | | (cm.) | | | | (Kg.) | | | | Single | | Married | | | | Other (Please specify) | | | | | | | | | | | |
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| | 8. | Date of Birth | | | | | | | | | | 9. | Place of Birth | | | | | | | | | | | | | | | | 10. | | Citizenship | | | | | | | | | | | | |
| | | DD | MM | YYYY | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
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| | 11. | Family Members: (Spouse, Children, Parents, Parents-in-Law) | | | | | | | | | | | | | | | | | | | Date of Birth | | | | | | | | |
| | | Name (Family Name, First Name) | | | | | | | | | | | | | | | | Relationship | | | | | | | DD | MM | YYYY | | | | | | | | |
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| | 12. | If you have a spouse, specify his/her current occupation. | | | | | | | | | | |
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| | 13. | Name of person to be notified in case of emergency | | | | | | | | | | | | | | | | | | | | | 10. | | Telephone Number | | | | | | | | | | |
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| | | Complete Address | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
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| | 14. | Have you obtained legal/permament residence status | | | 15. | Have you any relative in Asian Development Bank | | | 16. | Job Position preference | | | | | | | | |
| | | in any country other than that of your citizenship? | | | | | | | or other similar international organization? | | | | | | | | | | | | | | | | | | | | | |
| | | | Yes | | | | | | No | | | | | | | | Yes | | | | | | No | | | | 1st | | | | | | | | | |
| | | | If "Yes" which country and when? | | | | | | | | | | If "Yes" give name, relationship and organization: | | | 2nd | | | | | | | | | |
| | | | | | | | | | 3rd | | | | | | | | | |
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| ADB Form No. 380/00 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | March 2001 | | | | | | |
| | 17. | Beginning with your native language, enter all languages you know.Please indicate your proficiency by marking the appropriate box. | | | | | | | | | | | | | | | | | | |
| | | Language | | | | | | | | | | | | | Reading | | Writing | | Speaking | | Understanding | | | | | | | | |
| | | | | | | | | | | | | | | | | | Good | Fair | Slight | | Good | Fair | Slight | | Good | Fair | Slight | | Good | Fair | Slight | | | | | | | | |
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| | 18. | EDUCATION: (Please give full details) | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| | A. | Schools or other formal training or education from age 14 (e.g. High School, technical school or apprenticeship) | | | | | | | | | | | | | | | | | | | | | | | |
| | | | | | | | | | | | | | | Period of Attendance | | | | | | | | | | | | | | | | | | | | | | | | | |
| | | | | | | | | | | | | | | From | | To | | | | | | | | | | | Certificates, Awards or | | | | | | | | |
| | | Name, City and Country | | | | | | | MM | YYYY | | MM | YYYY | | Main Course of Study | | Distinctions Received | | | | | | | | |
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| | B. | University or Equivalent | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| | | | | | | | | | | | | | | Period of Attendance | | | | | | | | | | | | | | | | | | | | | | | | | |
| | | | | | | | | | | | | | | From | | To | | | | | | | | | | | Diploma/Degrees | | | | | | | | |
| | | Name, City and Country | | | | | | | MM | YYYY | | MM | YYYY | | Main Course of Study | | Equivalent | | | | | | | | |
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| | C. | Part-time Study Program | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| | | | | | | | | | | | | | | Period of Attendance | | | | | | | | | | | | | | | | | | | | | | | | | |
| | | | | | | | | | | | | | | From | | To | | | | | | | | | | | Degrees and Academic | | | | | | | | |
| | | Name, City and Country | | | | | | | MM | YYYY | | MM | YYYY | | Main Course of Study | | Distinctions Obtained | | | | | | | | |
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| | D. | Professional qualifications or specialized training (e.g. Certified Public Accountant, Chartered Secretary, Bar Admission, Banking, Engineering, etc.) | | | | | | | | | | | | | | |
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| | 19. | Other special qualifications in financial, development, or planning institutions. (Please give details.Use separate sheet, if necessary) | | | | | | | | | | | | | | | | | |
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| | 20. | Membership in professional societies and activities in civic, public, or international affairs. | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
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| | 21. | List significant publications you have written. (Do not attach) | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
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| | 22. | List all computer softwares which you are familiar with.Indicate your proficiency (i.e. "L" for low; "A" for average; "H" for High) | | | | | | | | | | | | | | | | | | | |
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| | 23. | Have you previously submitted an application in ADB? If "Yes", indicate date. | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| | | | | | | | | | | | | | | | | | | | | | | | | | | Yes | | | | No | | | | DD | MM | YYYY | | | | | | | | |
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| | 24. | Have you ever been employed by ADB (regular, consultant, contractual or temporary)? | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| | | If so, please provide details in your Employment Record in item below. | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| | | | | | | | | | | | | | | | | | | | | | | | | | | Yes | | | | No | | | | | | | | | | | | | | |
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| | 25. | EMPLOYMENT RECORD: (Starting with your present/latest job, list evry job you have had.Use a separate block for each job.Include also service | | | | | | | | | | | | | | |
| | | in the armed forces and periods during which you were not gainfully employed.If you need more space, atatch additional pages of the same size.) | | | | | | | | | | | | | | | |
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| | | From | | | To | | Annual Salary | | Position/Job Title: | | | | | | | | | | | | | | |
| | | DD | MM | YYYY | | | DD | MM | YYYY | | Starting | | Latest | | | | | | | | | | |
| | | | | | | | | | | | | | | | Name and Position of Supervisor: | | | | | | | | | | |
| | | Others (e.g. Bonuses, etc.) | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| | | | | Number and Category of Employees you Supervised: | | | | | | |
| | | Name and Address of Organization: | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| | | | | Reason for Leaving/Wanting to Leave: | | | | | | | | | |
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| | | Nature of Business: | | | | | | | | | | | | | | Telephone No. | | | | | | | | | | | | | | | | | |
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| | | Describe your Work: | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
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| | | From | | | To | | Annual Salary | | Position/Job Title: | | | | | | | | | | | | | | |
| | | DD | MM | YYYY | | | DD | MM | YYYY | | Starting | | Latest | | | | | | | | | | |
| | | | | | | | | | | | | | | | Name and Position of Supervisor: | | | | | | | | | | |
| | | Others (e.g. Bonuses, etc.) | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| | | | | No. and Category of Employees you Supervised: | | | | | | |
| | | Name and Address of Organization: | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| | | | | Reason for Leaving/Wanting to Leave: | | | | | | | | | |
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| | | Nature of Business: | | | | | | | | | | | | | | Telephone No. | | | | | | | | | | | | | | | | | |
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| | | Describe your Work: | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
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| | | From | | | To | | Annual Salary | | Position/Job Title: | | | | | | | | | | | | | | |
| | | DD | MM | YYYY | | | DD | MM | YYYY | | Starting | | Latest | | | | | | | | | | |
| | | | | | | | | | | | | | | | Name and Position of Supervisor: | | | | | | | | | | |
| | | Others (e.g. Bonuses, etc.) | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| | | | | No. and Category of Employees you Supervised: | | | | | | |
| | | Name and Address of Organization: | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| | | | | Reason for Leaving/Wanting to Leave: | | | | | | | | | |
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| | | Nature of Business: | | | | | | | | | | | | | | Telephone No. | | | | | | | | | | | | | | | | | |
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| | | Describe your Work: | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
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| - If you have had more than four jobs, attach additional pages to record them - | | | | | | |
| | | From | | | To | | Annual Salary | | Position/Job Title: | | | | | | | | | | | | | | |
| | | DD | MM | YYYY | | | DD | MM | YYYY | | Starting | | Latest | | | | | | | | | | |
| | | | | | | | | | | | | | | | Name and Position of Supervisor: | | | | | | | | | | |
| | | Others (e.g. Bonuses, etc.) | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| | | | | No. and Category of Employees you Supervised: | | | | | | |
| | | Name and Address of Organization: | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| | | | | Reason for Leaving/Wanting to Leave: | | | | | | | | | |
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| | | Nature of Business: | | | | | | | | | | | | | | Telephone No. | | | | | | | | | | | | | | | | | |
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| | | Describe your Work: | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
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| | 26. | State any other relevant facts.Include International experience, stating place and duration. | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
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| | 27. | Have you any objections to our making inquiries with your present employer? | | | | | | Yes | | | | No | | | | | | | | | | | | | | | | | | | |
| | | If yes, why? | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
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| | 28. | REFERENCES: List three persons, not related to you, who are familiar with your character, qualifications and competence whom ADB may contact at any time. | | | | | | | | | | | |
| | | Do not repeat names of the supervisor(s) listed under item 25. | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
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| | | Full Name and Job Title | | | | | | | | Full Address / E-mail / Fax | | | | | | | | | | | | | Name of Business | | | | | | | | | | | | | |
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| | 29. | Do you have physical defects or disabilities? | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
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| | | Yes | | | | No | | | If "Yes", please specify: | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
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| | 30. | Have you ever suffered from any serious nervous disorders or contagious diseases? | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
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| | | Yes | | | | No | | | If "Yes", give details. | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
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| | 31. | Are you physically able and willing to travel? | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
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| | | Yes | | | | No | | | | | | | By Air? | Yes | | | | No | | | | | | | Frequently | | | | Occassionally | | | | | | | | |
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| | 32. | Have you ever been arrested, indicted or summoned into court as defendant in a criminal proceeding or convicted, fined or imprisoned for the violation of any law | | | | | | | | | | | |
| | | (excluding minor traffic violations)? | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
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| | | Yes | | | | No | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
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| | 33. | Have you ever been discharged or forced to resign from any position? | | | | | | | Yes | | | | No | | | | | | | | | | | | | | | | | | | |
| | | If "Yes", give details: | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
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| | 34. | What approximate starting salary will be acceptable to you for the position you have in mind? (Professional staff are paid in US dollars.Local recuits are paid in local currency.) | | | | | | | | |
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| | | | | | | | | | | | | per month | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| | 35. | If your services are required at the earliest possible time, how soon will you be available to start work after being found suitable and physically fit for employment? | | | | | | | | | | | |
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| | | | Immediately | | | | Week's Time | | | | Other (Please specify) | | | | | | | | | | | | | | | | | | | | | | | | | |
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| | 36. | 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.Permission is given to | | | | | | | | |
| | | ADB to make such investigations as are necessary on the information given above. I understand that any misrepresentation or material omission made herein or in any | | | | | | | | | |
| | | other document requested by ADB renders a staff member liable to termination of service or dismissal. | | | | | | | | | | | | | | | | | | | | | | | | | |
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| | | Date: | | | | | | | | | | | | | | | Signature: | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
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| N.B. | You will be requested to supply documentation 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 ADB, and in any event, do not submit the original texts of reference or testimonials or publications unless they have been obtained forthe sole use of ADB. | | | | | | | |
| ADB Form No. 380/00 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | March 2001 | | | | | | |
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