State Fire Marshal Application
Section 1: Personal Information
1.1 Title: Mr
1.2 Forename(s): Jay
1.3 Surname(s): Teller
1.4 Other name(s): D.N.A.
1.5 Date of Birth: 22/FEB/1997
1.6 Weight: 175 lbs
1.7 Height 6 ft 1 ins
1.8 Primary place of residence: 107 Playa Vista, Floor 4, Room 4, Del Perro, Los Santos.
1.9 Contact Number: 52903733
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:
- Law Enforcement Studies - Greenglass College - Diploma
AR-15 Certified - Los Santos Sheriff's Department
Section 3: Employment History
Please list below your entire employment history, including your most recent agency service.
3.1 Most recent agency affiliation: Los Santos Sheriff's Department
3.2 Rank held: Deputy Sheriff
3.3 Tenure: 0 years, 3 months (16/NOV/2021 - 03/FEB/2022)
3.4 Please list any further affiliations or employment hereunder, including position and tenure:
- ULSA - Security Officer II (Oct 2022- Present)
ULSA - Security Officer I (OCT 2021-NOV 2021)
- Resignation from LSSD (( LSSD - OOC Discharge - MDC misuse))
Resignation from ULSA in 2021.
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.
- D.N.A.
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:
- Purchase Firearms
Guard Card
CCW
Hunting License
Section 6: Declaration
Replace and complete as appropriate the information hereunder:
Name (print): Jay TellerOn submitting this application, I, Jay Teller, 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): Jay Teller
Date: 23/DEC/2022
(( Section 7: OOC Information ))
7.1 Forum name: JulieArt
7.2 Geographical location and timezone: North America, EST
7.3 Character ID: 73875
7.4 Discord username: JulieArt~#4986
7.5 Please list languages in which you may be fluent in, alongside English: English.
7.6 How long have you been roleplaying on GTA:W, and roleplaying in total? Over a year on GTAW, about 7-8 for RP in general.
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: * Jay Teller provides a sample of all of their fingerprints to the Office of the State Fire Marshal at their Rockford Hills HQ on 23/DEC/2022
7.11 Drug test: * Jay Teller conducts a drug test at the SFM Rockford Hills Headquarters on 23/DEC/2022. It returns NEGATIVE