San Andreas Government

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

1.0 PERSONAL INFORMATION

1.1 Name:
First Name: Griff
Last Name: Griffin

1.2 Gender:
Male

1.3 Age, Date of Birth and Place of Birth:
Age: 23
Date of Birth: 1994-08-20
Place of Birth (City, State/Province, Country): Los Santos

1.4 Citizenship:
UsCitizen

1.5 Contact Details:
Phone Number: 294-6378

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?
No

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

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

2.5 List any Los Santos Emergency Services References you may have:
N/A

3.0 LICENSES AND CRIMINAL HISTORIES

3.1 Do you possess a valid driver's license in the State of San Andreas?
Yes

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



3.3 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 love helping people and would love to serve the nice people of los santos with my whole heart and soul

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

I love the medical field, ever since i was a kid i wanted to work as a public servent

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

5.1 About you:
Name/Nickname: Cody/ doc
Gender: Male
Age: 23
Country: United states
Timezone: Mountain
Discord name and ID: kspanicshot#3080

5.2 Have you ever been in the SAENS faction before? (applies to any character):
No

5.3 Please list any other characters you have on StoryRP, including their profession or side gigs:
i dont have any other character other than my current one

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:

6.0 RELEASE AND WAIVER

I, Griff Griffin, 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.