State Fire Marshal Application
Section 1: Personal Information
1.1 Title: Mr
1.2 Forename(s): Jerry
1.3 Surname(s): Emerson
1.4 Other name(s): N/A
1.5 Date of Birth: 10/12/1981
1.6 Weight: 172 lbs
1.7 Height 5ft 11ins
1.8 Primary place of residence: 1110C Imagination Court
1.9 Contact Number:3851142
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:
- Del Rio High School
High School Diploma
Tulsa Technical College
Vocational Electrical degree
Section 3: Employment History
Please list below your entire employment history, including your most recent agency service.
3.1 Most recent agency affiliation: Self Employed Electrician
3.2 Rank held: Self Employed
3.3 Tenure: 1 years, 0 months (22/04/2021)
3.4 Please list any further affiliations or employment hereunder, including position and tenure:
- United States Airforce
3E0X1 Electrical Systems
17/02/1999 - 04/07/2005
Johnson Electric
Journeyman Electrician
07/03/2006 - 10/10/2020
3.5 Please list hereunder reasons for dismissal within previous employment:
- LIST HERE
I did not reenlist in the Air Force, I went too school to get my degree from Tulsa Technical College while working for a family friend's electrician business. I left the family friend's business to move to Los Santos for my aging father's care.
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.
- I do wear prescription glasses for nearsightedness.
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.
Section 6: Declaration
Replace and complete as appropriate the information hereunder:
On submitting this application, I, Jerry Emerson, 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 (print): Jerry Emerson
Name (signed): Jerry Emerson
Date: 22/04/2022
(( Section 7: OOC Information ))
7.1 Forum name: stellabellum
7.2 Geographical location and timezone: United States, EST
7.3 Character ID: 77622
7.4 Discord username: WookieCookie#9798
7.5 Please list languages in which you may be fluent in, alongside English: None
7.6 How long have you been roleplaying on GTA:W, and roleplaying in total? December 2021 for GTA but I've been roleplaying on another platform for around 4 ish years.
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 Please write your character's background story:
7.10 Fingerprint sample: * Jerry Emerson provides a sample of all of their fingerprints to the Office of the State Fire Marshal at their Rockford Hills HQ on 22/04/2022.
7.11 Drug test: * Jerry Emerson conducts a drug test at the SFM Rockford Hills Headquarters on 22/04/2022. It returns Negative.