San Andreas Government

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

1.0 PERSONAL INFORMATION

1.1 Name:
First Name: John
Last Name: Bernasky

1.2 Gender:
Male

1.3 Age, Date of Birth and Place of Birth:
Age: 23
Date of Birth: 1998-03-02
Place of Birth (City, State/Province, Country): Romania, hunedoara

1.4 Citizenship:
NotUsCitizen

1.5 Contact Details:
Phone Number: 301-6175
Residence Address:
I don t have a specific adress right now

2.0 PAST EMPLOYMENT AND REFERENCES

2.1 What position are you applying for?
EMT

2.2 Do you have any experience in the position you are applying for?
I don t have

2.3 Do you have any first aid or medical certifications?
Nop

2.4 Can you speak to others in English proficiently?:
Yes

2.5 Can you write to others in English proficiently?:
Yes

2.6 List previous medical employment:


2.7 List any Los Santos Emergency Services References you may have:

3.0 LICENSES AND CRIMINAL HISTORIES

3.1 Are you certified to use a taser? No
If yes, where did you obtain your certification? Write ‘none’ if not applicable.
None

3.2 Do you have a Pilot License? No
If yes, where did you obtain your certification? Write ‘none’ if not applicable.
None

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:



3.6 Have you ever been charged with a misdemeanor? No
If yes, please explain:



3.7 Have you ever been arrested and/or convicted of a felony? No
If yes, please explain:

4.0 GENERAL QUESTIONS

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

I will bring some activity, good atitude, positivity, i will give some skills after then i will learn how to make my job, prosperity, devotament, some good jokes when we don t work. I will be very involved and try to help everyone and maybe a little prosperity

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

When I was little I always tried to help everyone, whether I managed or not, I wanted to be the man who is there for everyone and tries to help them. These things motivate me even more at the moment to help other people and because of that I want to be an EMS, in case of anything, to be the person who helps.

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

5.1 About you:
Name/Nickname: HaidiWa
Gender: Male
Age: 23
Country: Romania
Timezone: Gmt+2
Discord name and ID: HaidiWa#5341

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:
1 character in Sheriff department, Igor Karkaroff

5.4 List all the factions you are currently a part of (type N/A if none):
Sheriff with other character

5.5 Do you have any administrative punishments on your record?:
No

If yes, please explain:



5.6 Are you involved, and/or currently play on any other GTA-RP servers?:
Yes

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

If yes, please explain:
EMS

6.0 RELEASE AND WAIVER

I, John Bernasky, 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.