State Fire Marshal Application
Section 1: Personal Information
1.1 Title: Mr.
1.2 First Name: Oliver
1.3 Last Name: Cashesegra
1.4 Middle Name: N/A
1.5 Date of Birth: 20/MAY/1988
1.6 Weight: 178 lbs
1.7 Height 6 ft 0 ins
1.8 Primary place of residence: 2005 San Andreas Boulevard, 4th Floor, Room 2, Los Santos, San Andreas.
1.9 Contact Number: 79075097
1.10 Email Address: [email protected]
1.11 Please provide a passport photo (150x150) of you on the right top corner of this form.
Section 2: Educational History
Please list and elaborate on, in the space hereunder, the entirety of your formal education history, including details of qualifications:
- Big Pine High School 2002-2006.
Georgia Military College - 2007-2009 (Associate Degree in Criminal Justice)
Section 3: Employment History
Please list below your entire employment history, including your most recent agency service.
3.1 Most recent agency affiliation: Arcani Group
3.2 Rank held: Security Guard
3.3 Tenure: 03 Years, 02 Months (20/JUN/2020 - 10/SEP/2023)
3.4 Please list any further affiliations or employment hereunder, including position and tenure:
- Gruppe 6; Security Guard - 1 year
- Resignation, in order to pursue other career paths.
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.
- My left eye suffers from light sensitivity and I have a slight limp on my left side. I've acquired both of these conditions during my time in the military. I was injured during combat, my left leg being pierced by loose shrapnel, while my eyes had been exposed to a stun grenade. I've went through two surgeries in order to heal my wounds. In the present, I'm wearing prescribed glasses and I go on regular check-ups for my leg.
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:
- Personal Firearms License
Guard Card
CCW
Section 6: Declaration
Replace and complete as appropriate the information hereunder:
Name (print):Oliver CashesegraOn submitting this application, I, Oliver Cashesegra, 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):O. Cashesegra
Date: 14/SEP/2023
(( Section 7: OOC Information ))
7.1 Forum name:Rust.
7.2 Geographical location and timezone: Romania; GMT+2 (GMT+3 during summertime)
7.4 Discord username: rustinthenorth(Rust.#5226)
7.5 Please list languages in which you may be fluent in, alongside English: Romanian
7.6 How long have you been roleplaying on GTA:W, and roleplaying in total? I've joined GTA:W in 2020 and before that, I've roleplayed on text servers since 2014.
7.7 List ALL current and past character names. Include faction and rank if applicable.
- Archibald Shepherd
- Rustin Blackfield
- Oliver Cashesegra
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: * Oliver Cashesegra provides a sample of all of their fingerprints to the Office of the State Fire Marshal at their Rockford Hills HQ on 14/SEP/2023.
7.12 Drug test: * Oliver Cashesegra conducts a drug test at the SFM Rockford Hills Headquarters on 14/SEP/2023. It returns negative.