San Andreas Government

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

1.0 PERSONAL INFORMATION

1.1 Name:
First Name: Santiago
Last Name: Rodriguez

1.2 Gender:
Male

1.3 Age, Date of Birth and Place of Birth:
Age: 27
Date of Birth: 1994-09-27
Place of Birth (City, State/Province, Country): Spain

1.4 Citizenship:
NotUsCitizen

1.5 Contact Details:
Phone Number: 220-6793
Residence Address:
I dont curently have a residence because there are no rooms available.

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?
No,i dont have any experience in that position.

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:


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

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.
I dont have a certification to prove that i can use a taser.

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

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? Yes
If yes, please explain:



3.6 Have you ever been charged with a misdemeanor? Yes
If yes, please explain:



3.7 Have you ever been arrested and/or convicted of a felony? Yes
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 can bring to San Andreas Medical Service team at least a minimum activity and help the other people that needs help because everytime i did go to the PillBox i did not seen any EMS in there...

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

I want to apply to San Andreas Medical Service team because when i was a little kid my mom had a heart surgery and a medic called Davis Black saved my mom. I prayed till i hit 18 that my mom is gonna be alright and can perform her actions everyday again. And that is the reason why i want to get in the Medical Service team,to save people out there in Los Santos.

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

5.1 About you:
Name/Nickname: Paul Mihai
Gender: Male
Age: 14
Country: Romania
Timezone: GMT +3
Discord name and ID: PaulPeVinyl#8212

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:
Plec Diesel - Member of Vagos who is also hired at PDM.

5.4 List all the factions you are currently a part of (type N/A if none):
On Rodriguez Santiago none but on Plec Diesel im in Vagos and PDM

5.5 Do you have any administrative punishments on your record?:
Yes

If yes, please explain:
Yes,i did got a straight warn because i did META-GAMING when i was in the PD


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:
Yes,i am and im a police man in there but im not active almost everytime in that server.

6.0 RELEASE AND WAIVER

I, Santiago Rodriguez, 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.