State Fire Marshal Application
Section 1: Personal Information
1.1 Title: Mr.
1.2 Forename(s): Darby
1.3 Surname(s): Kelley
1.4 Other name(s):
1.5 Date of Birth: 20/10/1994
1.6 Weight: 224 lbs
1.7 Height 6 ft 2 ins
1.8 Primary place of residence: Bravado Youga 4x4 [KKQ537]
1.9 Contact Number: 6914
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:
- - Sandy Shores High School, Grade 12.
- Syracuse University, Bachelor of Science degree in Fire Protection Administration and Technology.
Section 3: Employment History
Please list below your entire employment history, including your most recent agency service.
3.1 Most recent agency affiliation: Sandy Shores Volunteer Fire Department
3.2 Rank held: Volunteer Firefighter.
3.3 Tenure: 10 years, 2 months (31/10/2011 - 03/01/2022)
3.4 Please list any further affiliations or employment hereunder, including position and tenure:
- Agency: Bernie & Sons Construction.
Rank Held: Bricklayer.
Tenure: 5 Years, 8 Months (15/04/2012 - 02/12/2018)
- Left for school.
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.
- 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:
- N/A
Section 6: Declaration
Replace and complete as appropriate the information hereunder:
Name (print): Darby Kelley.On submitting this application, I, Darby Kelley, 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): Darby Kelley.
Date: 07/01/2021
(( Section 7: OOC Information ))
7.1 Forum name: moulton
7.2 Geographical location and timezone: Nova Scotia, Canada - Atlantic Standard.
7.3 Character ID: 62745
7.4 Discord username: RJ#6889
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? Since 2005, Roleplaying on GTA:W for two-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: * Darby Kelley provides a sample of all of their fingerprints to the Office of the State Fire Marshal at their Rockford Hills HQ on 07/01/2022
7.11 Drug test: * Darby Kelley conducts a drug test at the SFM Rockford Hills Headquarters on 07/01/2022. It returns negative.