State Fire Marshal Application
Section 1: Personal Information
1.1 Title: Mr
1.2 Forename(s):Nathanial
1.3 Surname(s):Cooper
1.4 Other name(s):N/A
1.5 Date of Birth: 05/FEB/2000
1.6 Weight: 126 lbs
1.7 Height 6 ft 1 ins
1.8 Primary place of residence:Pink Cage Motel Room 20
1.9 Contact Number: 79279625
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:
- Columbia High School - Graduated 2018
ULSA - Psychology - Bachelors - Graduated 2022
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 Fire & Electronics
3.2 Rank held: Technician
3.3 Tenure: 0 years, 8 months (05/JUL/2022 - 10/FEB/2023)
3.4 Please list any further affiliations or employment hereunder, including position and tenure:
- N/A
- Resignation
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):Nathanial CooperOn submitting this application, I, Nathanial Cooper, 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):Nathanial Cooper
Date: 21/FEB/2023
(( Section 7: OOC Information ))
7.1 Forum name:quinny
7.2 Geographical location and timezone: USA & EST
7.3 Character ID:110856
7.4 Discord username: qqqq#2470
7.5 Please list languages in which you may be fluent in, alongside English:N/A
7.6 How long have you been roleplaying on GTA:W, and roleplaying in total? Since August 2022 and since march of 2020
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: * Nathanial Cooper provides a sample of all of their fingerprints to the Office of the State Fire Marshal at their Rockford Hills HQ on 21/FEB/2023.
7.11 Drug test: * Nathanial Cooper conducts a drug test at the SFM Rockford Hills Headquarters on 21/FEB/2023. It returns negative.