State Fire Marshal Application
Section 1: Personal Information
1.1 Title: Mr
1.2 Forename(s): Alex
1.3 Surname(s): Jorgensen
1.4 Other name(s):
1.5 Date of Birth: 11/JAN/1993
1.6 Weight: 250 lbs
1.7 Height 5 ft 7 ins
1.8 Primary place of residence: 3219 West Mirror Drive, Mirror Park, Los Santos, San Andreas
1.9 Contact Number: 40157261
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:
- San Fierro High School, San Fierro
LSFD Qualifications;
Lifeguard Qualification, EVOC-A, EVOC-B, EVOC-C, EVOC-D, EMT-B, Paramedic, Rescue Diver and RWC Operator as well as those relating to Aerial Operations such as Flight Crew and Aeromedic and Lifeguard Baywatch (Marine Operations) (( https://lsfd.gta.world/viewtopic.php?f=332&t=8919 ))
Section 3: Employment History
Please list below your entire employment history, including your most recent agency service.
3.1 Most recent agency affiliation: San Fire
3.2 Rank held: Public Information Officer
3.3 Tenure: 0 years, 1 months (01/NOV/2022 - Current)
3.4 Please list any further affiliations or employment hereunder, including position and tenure:
- Aurum Energy - Public Relations/Marketing Manager (June 2021 - November 2022)
LSFD - Volunteer Firefighter/Lifeguard/PR Director (January 2021 - June 2021)
Security Freelancer - Sinclair Security (Current)
SAMRA/SAASCAR - PR Advisor (Current)
Hope Health - Volunteer (October 2020 - June 2021)
- State Fire Marshals - Resignation (( OOC Dismissal (Covered in faction ban appeal))
LSFD - Retirement
Aurum Energy - Resignation to move on to employment with San Fire
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.
- Previous trapped nerve in shoulder from Lifeguard duties, since treated via surgery.
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:
- Personal Firearms License, Conceal Carry License, Guardcard
Section 6: Declaration
Replace and complete as appropriate the information hereunder:
Name (print): Alex JorgensenOn submitting this application, I, Alex Jorgensen, 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):
Date: 1/DEC/2022
(( Section 7: OOC Information ))
7.1 Forum name: Jorgensen
7.2 Geographical location and timezone: Bristol, UK GMT+1
7.3 Character ID: 49041
7.4 Discord username: Jorgensen#2982
7.5 Please list languages in which you may be fluent in, alongside English: Welsh
7.6 How long have you been roleplaying on GTA:W, and roleplaying in total? Since 2017 on GTAWorld, I have been roleplaying since 2009 though.
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: * Alex Jorgensen provides a sample of all of their fingerprints to the Office of the State Fire Marshal at their Rockford Hills HQ on 01/DEC/2022.
7.11 Drug test: * Alex Jorgensen conducts a drug test at the SFM Rockford Hills Headquarters on 01/DEC/2022. It returns Negative.