State Fire Marshal Application
Section 1: Personal Information
1.1 Title: Mr
1.2 First Name: Carter
1.3 Last Name: Jackson
1.4 Middle Name: D.N.A
1.5 Date of Birth: 18/JUL/2000
1.6 Weight: 187 lbs
1.7 Height 6 ft 2 ins
1.8 Primary place of residence:
1.9 Contact Number: 28182852
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:
- 2005-2012 - Los Santos Elementary School
2012 - 2015 - Los Santos Middle School
2015 - 2018 - Los Santos High School (GPA 3.67)
Section 3: Employment History
Please list below your entire employment history, including your most recent agency service.
3.1 Most recent agency affiliation: Full Throttle Racing
3.2 Rank held: Chief Operating Officer
3.3 Tenure: 0 years, 7 months (05/JUN/2023 - 19/JAN/2024)
3.4 Please list any further affiliations or employment hereunder, including position and tenure:
- Senora Logistics, Senior Trucker, 0 years, 1 month (20/DEC/2023 - 19/JAN/2024)
- D.N.A
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): CARTER JACKSONOn submitting this application, I, Carter Jackson, 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): C. Jackson
Date: 19/JAN/2024
(( Section 7: OOC Information ))
7.1 Forum name: Clim
7.2 Geographical location and timezone: Jersey, Saint Helier, GMT+0
7.4 Discord username: Climerus
7.5 Please list languages in which you may be fluent in, alongside English: D.N.A
7.6 How long have you been roleplaying on GTA:W, and roleplaying in total? 2017, 173.6
7.7 List ALL current and past character names. Include faction and rank if applicable.
- Past Character -> (Past) Maxim Malikov -> (Past) Mason Hauser -> (Current) Carter Jackson (No affiliate factions)
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: * Carter Jackson provides a sample of all of their fingerprints to the Office of the State Fire Marshal at their Rockford Hills HQ on 19/JAN/2024.
7.12 Drug test: * Carter Jackson conducts a drug test at the SFM Rockford Hills Headquarters on 19/JAN/2024. It returns NEGATIVE.