San Andreas Government

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

1.0 PERSONAL INFORMATION

1.1 Name:
First Name: Angel
Last Name: Martinez

1.2 Gender:
Male

1.3 Age, Date of Birth and Place of Birth:
Age: 22
Date of Birth: 1999-04-04
Place of Birth (City, State/Province, Country): new york, america

1.4 Citizenship:
UsCitizen

1.5 Contact Details:
Phone Number: 3156181
Residence Address:
grove street

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 have been emt many other times in other cities

2.3 Do you have any first aid or medical certifications?
no

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:
Maplehearts EMT, glam, 105k, 200k, Maplehearts

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? Yes
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?
Yes

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):

what I offer to the san Andreas medical services team is that I'm a dedicated, hard-working individual who stands out from the rest because of my courage and integrity. Another strength of mine is teamwork which is very key in an industry like this. Lastly, I feel my mission in this world is to help others and save lives.

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

Like I said above I feel my mission in this world is to save lives/ help people in need and I feel that in this job I will be doing both. Lastly, as a child, I was diagnosed with throat cancer and without those hard-working amazing doctors, I wouldn't be where i am today so I feel it's my mission to be an EMT.

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

5.1 About you:
Name/Nickname: adotlol
Gender: Male
Age: 16
Country: America
Timezone: est
Discord name and ID: adotlol#1607

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:
none

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

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?:
No

5.6.1 If yes to 5.6, are you involved in any factions there?:
No

If yes, please explain:

6.0 RELEASE AND WAIVER

I, Angel Martinez, 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.