State Fire Marshal Application
Section 1: Personal Information
1.1 Title: Ms
1.2 Forename(s): Nicolle
1.3 Surname(s): Diaz
1.4 Other name(s): Marie
1.5 Date of Birth: 03/06/1999
1.6 Weight: 125 lbs
1.7 Height 5 ft 7 inch
1.8 Primary place of residence: Perrara Motel 16, Del Perro Marathon Ave.
1.9 Contact Number: (468) 23596
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:
- Davis high school - Graduate
University of Los Santos - Graduate in Medicine & Natural Science. I have been graduate with a 3.54 GPA.
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 Public Library
3.2 Rank held: Library Assistant
3.3 Tenure: 2 years (21/09/2018 to 02/10/2020)
3.4 Please list any further affiliations or employment hereunder, including position and tenure:
- N/A
- Voluntary (I needed more time for my university career.)
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): Nicolle DiazOn submitting this application, I, Nicolle Diaz, 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): Nicolle Diaz
Date: 06/07/2022
(( Section 7: OOC Information ))
7.1 Forum name: noisebutters
7.2 Geographical location and timezone: AST-4, from Puerto Rico
7.3 Character ID: 88117
7.4 Discord username: Sauce#0299
7.5 Please list languages in which you may be fluent in, alongside English: English, Spanish
7.6 How long have you been roleplaying on GTA:W, and roleplaying in total? Roleplaying since 2016, GTA W since APRIL 2022.
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: * Nicolle Diaz provides a sample of all of their fingerprints to the Office of the State Fire Marshal at their Rockford Hills HQ on 06/07/2022.
7.11 Drug test: * Nicolle Diaz conducts a drug test at the SFM Rockford Hills Headquarters on 06/07/2022. It returns negative.