[SAMS Application] Arnold Williams

[Arnold Williams]

San Andreas Emergency Medical Services
SAEMS Application
"TO PROTECT AND TO SERVE"

1.0 PERSONAL INFORMATION

1.1 Name:
First Name: Arnold
Last Name: Williams

1.2 Gender:
Male

1.3 Age, Date of Birth and Place of Birth:
Age: 234
Date of Birth: 2021-09-02
Place of Birth (City, State/Province, Country): adasd

1.4 Citizenship:
NotUsCitizen

1.5 Contact Details:
Phone Number: 3423423
Residence Address:
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2.0 PAST EMPLOYMENT AND REFERENCES

2.1 What position are you applying for?
Doctor/Surgeon

2.2 Do you have any experience in the position you are applying for?
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2.3 Do you have any first aid or medical certifications?
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2.4 Can you speak to others in English proficiently?:
Yes

2.5 Can you write to others in English proficiently?:
No

2.6 List previous medical employment:
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2.7 List any Los Santos Emergency Services References you may have:
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3.0 LICENSES AND CRIMINAL HISTORIES

3.1 Are you certified to use a taser? Yes
If yes, where did you obtain your certification? Write ‘none’ if not applicable.
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3.2 Do you have a Pilot License? Yes
If yes, where did you obtain your certification? Write ‘none’ if not applicable.
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3.3 Do you possess a valid driver's license in the State of San Andreas?
Yes

3.4 Do you possess a valid firearm's license?
No

3.5 Have you ever been issued a citation? No
If yes, please explain:
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3.6 Have you ever been charged with a misdemeanor? No
If yes, please explain:
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3.7 Have you ever been arrested and/or convicted of a felony? No
If yes, please explain:
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4.0 GENERAL QUESTIONS

4.1 Describe what you could bring to the San Andreas Medical Services team? (minimum of 50 words):

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4.2 hat inspired you to apply for the San Andreas Medical Services team? (minimum of 50 words):

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(( 5.0 OUT-OF-CHARACTER INFORMATION AND QUESTIONS ))

5.1 About you:
Name/Nickname: Pertinax
Gender: Male
Age: 214
Country: costa
Timezone: -6 mgt
Discord name and ID: ertinax#5312

5.2 Have you ever been in the SAENS faction before? (applies to any character):
Yes

5.3 Please list any other characters you have on StoryRP, including their profession or side gigs:
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5.4 List all the factions you are currently a part of (type N/A if none):
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5.5 Do you have any administrative punishments on your record?:
No

If yes, please explain:
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5.6 Are you involved, and/or currently play on any other GTA-RP servers?:
No

5.6.1 If yes to 5.6, are you involved in any factions there?:
Yes

If yes, please explain:
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6.0 RELEASE AND WAIVER

I, Arnold Williams, hereby certify that the above statements are true and correct to the best of my knowledge. I understand that a false statement may disqualify my application and could result in immediate termination.
San Andres Medical Services provides training for all applicants regardless of previous experience. I agree that I may be subject to cross-training in the event of a city wide emergency. By submitting this document, I agree to adhere to all San Andres Medical Services protocols and procedures.

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By submitting this document, I agree to perform to the best of my ability where needed, without prejudice or malice. I agree to follow HIPAA laws, and any information obtained during the probationary period is protected through HIPAA. I understand that San Andreas Medical Services and the State of California reserve the right to pursue legal action if found to have violated information during my employment with San Andreas Medical Services.