[AmeriCare] EMT Application Template

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Katherine Gayle
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[AmeriCare] EMT Application Template

Post by Katherine Gayle » April 30th, 2019, 1:39 am

To apply for employment with AmeriCare please fill out the following form, and post it . The post subject should be formatted as followed; [Employment Application] Forename Surname.
Image
AMERICARE - AMBULANCE SERVICE
LOS SANTOS REGIONAL OFFICE

Personal information Please provide accurate personal information in fields A1 through A12 as it's shown on your San Andreas Drivers License or Identification Card.
  • A1. Last Name:
    A2. First Name:
    A3. Middle Name:

    A4. Date of Birth: DD/MMM/YYYY
    A5. Phone Number:
    A6. County of citizenship:
    A7. Residence Address:

    A8. Height: 0'0
    A9. Weight: 0 lbs
    A10. Sex
    • [-] Male
      [-] Female
    A11. Do you now possess a valid San Andreas driver's license?
    • [-] Yes
      [-] No
    A12. Do you now possess a valid EMT-B license?
    • [-] Yes
      [-] No
Image
AMERICARE - AMBULANCE SERVICE
LOS SANTOS REGIONAL OFFICE

Educational background Please provide information as it pertains to your educational background in sections through B1 through B5. All applicants must at least have a High-school Diploma, or a General Education Diploma (GED) to be considered for employment.
  • B1. Please check the boxes if you meet the requirement:
    • [-] I possess a high school diploma from a US institution.
      [-] I possess a two-year college degree from an accredited college.
      [-] I possess a four-year degree from an accredited college or university.
      [-] I passed the GED test meeting the required scores.
    B2. If you have attended college, what was your major course of study?
    • [-] Criminal Justice
      [-] Business/Economics
      [-] General Ed/Undecided
      [-] Engineering/Computer
      [-] Communications
      [-] Psychology/Sociology
      [-] Liberal Arts
      [-] Education
      [-] Science
      [-] Other
    B3. Name of the institution of the highest education achieved:
    B4. Type of institution:
    B5. Graduation date: DD/MMM/YYYY
Image
AMERICARE - AMBULANCE SERVICES
LOS SANTOS REGIONAL OFFICE

Previous employment In fields C1 through C3 please provide any pertinent past employment information that can be verified through contact.
C1. Please check the boxes if you meet the requirement:
  • • Company Name:
    • Position:
    • Specific Duties:
    • Reason for leaving:
    • Employed from - to: DD/MMM/YYYY - DD/MMM/YYYY

    • Company Name:
    • Position:
    • Specific Duties:
    • Reason for leaving:
    • Employed from - to: DD/MMM/YYYY - DD/MMM/YYYY
C2. If you have served in the military, please indicate which branch:
  • [-] Army
    [-] Navy
    [-] Air Force
    [-] Marines
    [-] Coast Guard
    [-] National Guard
    [-] Reserves
C3. Does your employment history include any of the following?
  • [-] Terminated from any job or resigned to avoid termination
    [-] History of discipline, unsatisfactory work performance, absenteeism, or tardiness
    [-] No history of achievement through promotion or increased responsibilities
    [-] Numerous short-term, entry-level jobs in a variety of fields

Image
AMERICARE - AMBULANCE SERVICES
LOS SANTOS REGIONAL OFFICE

Certification and Declerations Please read and sign the declaration and certification at the bottom of the application.

By submitting this application to AmeriCare - Ambulance Service, I, consent to a full background check into my criminal, education, and employment history. In addition, I, certify under penalty of the law that all information submitted in this application and provided during my consideration for employment is truthful.

I hereby certify that all statements and answers made in this Application are true and complete. I understand that any discrepancies, misstatements, omissions, and/or falsifications will be cause for disqualification, for my name to be removed from the eligibility list, or for immediate termination if an appointment has been made.

Applicant's signature: Firstname Lastname
(( Out of character Information )) D1.Real Life Country of Residence:
D2.LS-RP Forum Account Profile Link:
D3.How long have you played on the server?:


D4. List all current and past character names, on every account, and their levels:
  • 1)
    2)
    3)
    4)
    5)
D5. Link an unedited screenshot of your admin record for all your characters on every account:
  • 1)
    2)
    3)
    4)
    5)
I hereby certify that all out of character statements made in this Application are true and complete. I understand that any discrepancies, misstatements, omissions, and/or falsifications will be cause for disqualification and for my name to be forwarded to server administration for possible administrative punishment. I confirm that I have not been banned from applying for the company and will take full responsibility for any policy violation. I agree that the company has every right to deny my application or ban me from applying for whatever reason(s).

Applicant's signature:

Code: Select all

[divbox=white][center][img]https://i.imgur.com/ToHVRdV.png[/img][/center]
[line][/line]
[center][font=Arial][b][size=150]AMERICARE - AMBULANCE SERVICE[/size][/b]
[size=115]LOS SANTOS REGIONAL OFFICE[/size][/font][/center]
[line][/line]
[center][b][size=150]Personal information[/size][/b][/center]

[b]Please provide accurate personal information in fields A1 through A12 as it's shown on your San Andreas Drivers License or Identification Card.[/b]
[hr]
[list=none][b]A1.[/b] Last Name:
[b]A2.[/b] First Name:
[b]A3.[/b] Middle Name:

[b]A4.[/b] Date of Birth: DD/MMM/YYYY
[b]A5.[/b] Phone Number:
[b]A6.[/b] County of citizenship:
[b]A7.[/b] Residence Address:

[b]A8.[/b] Height: 0'0
[b]A9.[/b] Weight: 0 lbs
[b]A10.[/b] Sex
[list=none][-] Male
[-] Female
[/list]

[b]A11.[/B] Do you now possess a valid San Andreas driver's license?
[list=none][-] Yes
[-] No
[/list]

[b]A12.[/B] Do you now possess a valid Basic Life Support practice license?
[list=none][-] Yes
[-] No
[/list]

[/divbox]
[divbox=white][center][img]https://i.imgur.com/ToHVRdV.png[/img][/center]
[line][/line]
[center][size=150]AMERICARE - AMBULANCE SERVICE[/size] 
[size=125][b]LOS SANTOS REGIONAL OFFICE[/b][/size][/center]
[hr][/hr]
[center][b][size=150]Educational background[/size][/b][/center]

[b]Please provide information as it pertains to your educational background in sections through B1 through B5. All applicants must at least have a High-school Diploma, or a General Education Diploma (GED) to be considered for employment.[/b]
[hr]
[list=none][b]B1.[/B] Please check the boxes if you meet the requirement:
[list=none][-] I possess a high school diploma from a US institution.
[-] I possess a two-year college degree from an accredited college.
[-] I possess a four-year degree from an accredited college or university.
[-] I passed the GED test meeting the required scores.
[/list]

[b]B2.[/B] If you have attended college, what was your major course of study?
[list=none][-] Criminal Justice
[-] Business/Economics
[-] General Ed/Undecided
[-] Engineering/Computer
[-] Communications
[-] Psychology/Sociology
[-] Liberal Arts
[-] Education
[-] Science
[-] Other
[/list]

[b]B3.[/B] Name of the institution of the highest education achieved:
[b]B4.[/B] Type of institution:
[b]B5.[/B] Graduation date: DD/MMM/YYYY

[/divbox][divbox=white][center][img]https://i.imgur.com/ToHVRdV.png[/img][/center]
[line][/line]
[center][size=150]AMERICARE - AMBULANCE SERVICES[/size] 
[size=125][b]LOS SANTOS REGIONAL OFFICE[/b][/size][/center]
[hr][/hr]
[center][b][size=150]Previous employment[/size][/b][/center]
[b]In fields C1 through C3 please provide any pertinent past employment information that can be verified through contact.[/b]
[hr]
[b]C1.[/B] Please check the boxes if you meet the requirement:
[list=none]• Company Name:
• Position:
• Specific Duties:
• Reason for leaving:
• Employed from - to: DD/MMM/YYYY - DD/MMM/YYYY

• Company Name:
• Position:
• Specific Duties:
• Reason for leaving:
• Employed from - to: DD/MMM/YYYY - DD/MMM/YYYY
[/list]
[b]C2.[/B] If you have served in the military, please indicate which branch:
[list=none][-] Army
[-] Navy
[-] Air Force
[-] Marines
[-] Coast Guard
[-] National Guard
[-] Reserves
[/list]
[b]C3.[/B] Does your employment history include any of the following?
[list=none][-] Terminated from any job or resigned to avoid termination
[-] History of discipline, unsatisfactory work performance, absenteeism, or tardiness
[-] No history of achievement through promotion or increased responsibilities
[-] Numerous short-term, entry-level jobs in a variety of fields
[/list]
[hr]

[/divbox][divbox=white][center][img]https://i.imgur.com/ToHVRdV.png[/img][/center]
[line][/line]
[center][size=150]AMERICARE - AMBULANCE SERVICES[/size] 
[size=125][b]LOS SANTOS REGIONAL OFFICE[/b][/size][/center]
[hr][/hr]
[center][b][size=150]Certification and Declerations[/size][/b][/center]
[b]Please read and sign the declaration and certification at the bottom of the application. [/b]

[i]By submitting this application to AmeriCare - Ambulance Service, I, consent to a full background check into my criminal, education, and employment history. In addition, I, certify under penalty of the law that all information submitted in this application and provided during my consideration for employment is truthful. [/i]

[i]I hereby certify that all statements and answers made in this Application are true and complete. I understand that any discrepancies, misstatements, omissions, and/or falsifications will be cause for disqualification, for my name to be removed from the eligibility list, or for immediate termination if an appointment has been made.[/i]

Applicant's signature: Firstname Lastname
[/divbox]
[divbox=white][center] [size=150][b](( Out of character Information ))[/b][/size][/center]

[b]D1.[/B]Real Life Country of Residence:
[b]D2.[/B]LS-RP Forum Account Profile Link:
[b]D3.[/B]How long have you played on the server?:


[b]D4.[/B] List all current and past character names, on every account, and their levels:
[list=none]1)
2)
3)
4)
5)
[/list]
[b]D5.[/B] Link an unedited screenshot of your admin record for all your characters on every account:
[list=none]1)
2)
3)
4)
5)
[/list]

[i]I hereby certify that all out of character statements made in this Application are true and complete. I understand that any discrepancies, misstatements, omissions, and/or falsifications will be cause for disqualification and for my name to be forwarded to server administration for possible administrative punishment. I confirm that I have not been banned from applying for the company and will take full responsibility for any policy violation. I agree that the company has every right to deny my application or ban me from applying for whatever reason(s).[/i]

Applicant's signature:
Image

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