San Andreas Government

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

1.0 PERSONAL INFORMATION

1.1 Name:
First Name: Tony
Last Name: Gambino

1.2 Gender:
Male

1.3 Age, Date of Birth and Place of Birth:
Age: 32
Date of Birth: 1989-09-23
Place of Birth (City, State/Province, Country): Caucasian

1.4 Citizenship:
UsCitizen

1.5 Contact Details:
Phone Number: 2137-6324
Residence Address:

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?
Yes RP

2.3 Do you have any first aid or medical certifications?
Yes RP

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?
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):

Most Realistic Roleplay Experience as A EMT/Doctor. I am very kind and professional and Hold myself to high standards. I am FRS (First Response Certified) From my former City. I am trained in First Aide/CPR that involve in life saving scenarios. Im familar with checking BPMs Pulse and can administer Drugs.

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

The practice of saving lives has always been very special to me. Ever since I was little, I wanted to be in that exact Professional adventure. (OOC)- I started my Roleplay experience being a EMT and ever since that moment, there is just something about saving life that really interest me. Being a EMT has alot of benefits, You become a Hero to alot of people. That is exactly what I have planned.

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

5.1 About you:
Name/Nickname: Benjamin S
Gender: Male
Age: 32
Country: USA
Timezone: EST
Discord name and ID: buckeye89#3740

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:
Tony Gambino

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

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?:
No

If yes, please explain:

6.0 RELEASE AND WAIVER

I, Tony Gambino, 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.