State Fire Marshal Application
Section 1: Personal Information
1.1 Title: Mr
1.2 Forename(s): Matthew
1.3 Surname(s): Coburn
1.4 Other name(s): Paul
1.5 Date of Birth: 9/FEB/1991
1.6 Weight: 181 lbs
1.7 Height 6 ft 1 ins
1.8 Primary place of residence: 0708 Alta Street, Floor 2, Room 1
1.9 Contact Number: 2990
1.10 Email Address: [email protected]
Section 2: Educational History
Please list and elaborate on, in the space hereunder, the entirety of your formal education history, including details of qualifications:
- Ceder Crest University (Bachelor Degree in Criminal Justice) -- Ceder Crest High School.
Section 3: Employment History
Please list below your entire employment history, including your most recent agency service.
3.1 Most recent agency affiliation: Holland Private Security
3.2 Rank held: Supervisor Operations / Range Instructor
3.3 Tenure: X years, X months (28/FEB/2020 - Present)
3.4 Please list any further affiliations or employment hereunder, including position and tenure:
- N/A
- Personal resignation due to interest shown in the State Fire Marshal.
Section 4: Medical History
Please list and elaborate on, in the space hereunder, any medical conditions you may have. In addition, please elaborate on any sections of your medical record which may hinder your ability to conduct your duties.
- None.
Section 5: Licensing, Permits and Legalities
5.1 Are you in possession of a valid Driver's License? Yes
5.2 Are you a lawful citizen of the State of San Andreas? Yes
5.3 Please list hereunder any other licenses or permits you are in possession of:
- PF license, CCW, GC, and Hunting licenses.
Section 6: Declaration
Replace and complete as appropriate the information hereunder:
Name (print): Matthew Paul CoburnOn submitting this application, I, Matthew Coburn, understand and confirm that all questions herein were responded to with truthfulness and integrity. I give my permission for the recruitment team to investigate, and to clarify, the information given, for the purpose of validation of this application. I acknowledge the fact that any plagiarism, perjury, or alteration of the contents within this document will result in the application being rejected, and a life-long ban from future applications to the Office of the State Fire Marshal.
Name (signed): Matthew P.Coburn
Date: 1st/AUG/2021
(( Section 7: OOC Information ))
7.1 Forum name: Hendrixx20
7.2 Geographical location and timezone: Egypt-Cairo / GMT+2
7.3 Character ID:56370
7.4 Discord username: Seif#3544
7.5 Please list languages in which you may be fluent in, alongside English: Arabic
7.6 How long have you been roleplaying on GTA:W, and roleplaying in total? Near the thousand hours and minor experience in different FIVEM RP Servers.
7.7 Please provide an unedited screenshot of your entire admin record: ACCESS
7.8 Please provide an unedited screenshot of your character statistics summary: ACCESS
7.9 Fingerprint sample: * Matthew Coburn provides a sample of all of their fingerprints to the Office of the State Fire Marshal at their Rockford Hills HQ on 30/JULY/2021.
7.10 Drug test: * Matthew Coburn conducts a drug test at the SFM Rockford Hills Headquarters on 30/JULY/2021. It returns Negative.
