State Fire Marshal: Reinstatement Form
Section 1: Personal Information
1.1: Title (Delete as appropriate): Mr
1.2: Forename(s): Tobias
1.3: Surname(s): Kaczmarek
1.4: Other name(s):
1.5: Date of Birth: 21/JAN/1986
1.6: Primary place of residence: 6818 Legacy Park Drive
1.7: Contact Number: 1903
1.8: Email Address: [email protected]
Section 2: Employment History
Please list below your employment history since being discharged from the Office of the State Fire Marshal.
LIST HERE: Indiana Fire Investigation Task Force
2.1: Please list hereunder reasons for dismissal within previous employment:
N/A
Section 3: Medical History
Please list and elaborate on, in the space hereunder, any updates to your medical history since your previous discharge from the Office of the State Fire Marshal.
N/A
Section 4: Re-employment
4.1: Why do you want to reinstate to the Office of the State Fire Marshal?
(( Truth be told, I was demotivated, but I do lowkey miss it, and I want back in. ))
4.2: What have you been doing since your discharge from the Office, and how has this had an impact on you and your decision to request reinstatement?
N/A
(( 4.3: Why did you leave the Office of the State Fire Marshal? ))
(( Demotivation ))
4.4: What was your previous rank?:
Region Chief
Section 5: Declaration
Replace and complete as appropriate the information hereunder:
On submitting this application, I, Tobias Kaczmarek, 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): Tobias Kaczmarek
Name (signed): T. Kaczmarek
Date: 23/FEB/2023
(( Section 6: OOC Information ))
7.1: Forum name: Ducky.
7.2: Discord username (Optional):
7.3: Please provide an unedited screenshot of your entire admin record:
7.4: Please provide an unedited screenshot of your character statistics summary:
7.5: Drug test: * Tobias Kaczmarek conducts a drug test at the Vespucci HQ on 23/FEB/2023. It returns NEGATIVE