State Fire Marshal Application
Section 1: Personal Information
1.1 Title: Mr
1.2 Forename(s):Ignacio
1.3 Surname(s):Loza
1.4 Other name(s): DNA
1.5 Date of Birth: 05/20/1998
1.6 Weight: 170 lbs
1.7 Height 5 ft 9 ins
1.8 Primary place of residence: 1205 Vespucci Blvd, Los Santos, San Andreas
1.9 Contact Number: 531071
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:
- Del Rio High School (2013 - 2017)
Section 3: Employment History
Please list below your entire employment history, including your most recent agency service.
3.1 Most recent agency affiliation: Davis 24/7
3.2 Rank held: Cashier
3.3 Tenure: 1 years, 2 months (02/FEB/2020 - 17/APR/2021)
3.4 Please list any further affiliations or employment hereunder, including position and tenure:
- DNA
- 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.
- DNA
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:
- DNA
Section 6: Declaration
Replace and complete as appropriate the information hereunder:
Name (print):Ignacio LozaOn submitting this application, I, Ignacio Loza, 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):Ignacio Loza
Date: 13/08/2023
(( Section 7: OOC Information ))
7.1 Forum name: Moya
7.2 Geographical location and timezone: GMT+2
7.4 Discord username: smrle
7.5 Please list languages in which you may be fluent in, alongside English: DNA
7.6 How long have you been roleplaying on GTA:W, and roleplaying in total? A few months
7.7 List ALL current and past character names. Include faction and rank if applicable.
- Fabian Lopez -> Isaac Aguila -> Ruben Pozo
- Ismael Howe -> Alex Powell -> Ignacio Loza
7.9 Please provide an unedited screenshot of your character statistics summary: ACCESS
7.10 Please write your character's background story (Minimum 250 words.): 7.11 Fingerprint sample: * Ignacio Loza provides a sample of all of their fingerprints to the Office of the State Fire Marshal at their Rockford Hills HQ on 13/08/2023.
7.12 Drug test: * Ignacio Loza conducts a drug test at the SFM Rockford Hills Headquarters on 13/08/2023. It returns Negative.