State Fire Marshal Application
Section 1: Personal Information
1.1 Title: Mr
1.2 First Name: Trent
1.3 Last Name: Roycewicz
1.4 Middle Name: D.N.A
1.5 Date of Birth: 05/MAY/1995
1.6 Weight: 195 lbs
1.7 Height 6 ft 0 ins
1.8 Primary place of residence: West Eclipse Boulevard, Richman Hotel - Apartment 101
1.9 Contact Number: 37140426
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:
- Whitney M. Young Magnet High School - General Education Diploma (21/AUG/2001 to 06/JUN/2013)
Loyola University Chicago - Bachelor of Social Work Degree (28/AUG/2013 to 28/JUN/2016)
Loyola University Chicago - Master of Social Work Degree (28/AUG/2016 to 28/JUN/2018)
Section 3: Employment History
Please list below your entire employment history, including your most recent agency service.
3.1 Most recent agency affiliation: Illinois Department of Children and Family Services
3.2 Rank held: Child Protection Specialist
3.3 Tenure: 3 years, 2 months (14/MAY/2019 - 15/JUL/2022)
3.4 Please list any further affiliations or employment hereunder, including position and tenure:
- D.N.A
- Formal 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.
- D.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:
- D.N.A
Section 6: Declaration
Replace and complete as appropriate the information hereunder:
Name (print): Trent RoycewiczOn submitting this application, I, Trent Roycewicz, 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):
Date: 14/JAN/2024
(( Section 7: OOC Information ))
7.1 Forum name: DeSync
7.2 Geographical location and timezone: Romania - Eastern European Time (GMT+3)
7.4 Discord username: espressy.depressy
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 have been roleplaying for more than nine years in total, on various platforms. I first started on private forum platforms when they were a trend back in the day, before moving on to SA:MP and journeying through a few Romanian and English speaking hard roleplay communities. By the time this application is sent, I have been roleplaying on GTA:W for almost 10 months.
7.7 List ALL current and past character names. Include faction and rank if applicable.
- Andrew Kevorkian (Volkovskaya Bratva - Obshchak)
- Meave Hayes
- Andrew Roycewicz -> Trent Roycewicz
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: * Trent Roycewicz provides a sample of all of their fingerprints to the Office of the State Fire Marshal at their Rockford Hills HQ on 14/JAN/2024.
7.12 Drug test: * Trent Roycewicz conducts a drug test at the SFM Rockford Hills Headquarters on 14/JAN/2024. It returns negative.