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- Gender:
- [X] Male [] Female [] Other (Please Specify On Line Below)
- ________________________
- Race:
- [X] Caucasian [] African-American [] Native American
- [] Asian (Japense) [] Asian (Other) [] Atzlander
- [] Other (Please Specify On Line Below)
- ________________________
- Metatype
- [X] Human [] Dwarf [] Ork
- [] Elf [] Troll
- [] Other, including Metavariants (Please Specify On Line Below))
- ________________________
- Are you Awakened or Emerged?
- [] Yes [X] No
- If you answered Yes to question 3, please specify type of Awakening or Emergence:
- [] Mage [] Adept
- [] Mystic Adept [] Technomancer
- Below, please note specialty.
- [] Primary Combatant ('Street Samurai') [] Hacker [X] Rigger
- [] Infiltrator [] Spellcaster (if Mage or MystAd) [] Summoner (if Mage or MystAd)
- [] Face
- Below, please note secondary ability.
- [] Secondary Combatant [X] Hacker [] Rigger
- [] Infiltrator [] Spellcaster (if Mage or MystAd) [] Summoner (if Mage or MystAd)
- [] Face [] None (Hyper-Specialist)
- Below, please select any common ailments.
- [] Burnout Awakened/Emerged [] Cyberpsychotic [] Combat Monster
- [] Addiction (PLease specify on line below) [X] SINner
- [] Allergy (Please specify on line below) [] Corporate Ties
- [] Dealt With Dragons
- ________________________
- in the two lines below, please list all fields in which you have contacts.
- __Advanced Robotics and Mechatronics (Academic), Electrical Engineering (Academic), Open-Source Programming Circle, Warez House, Grey Market military surplus provider (survivalist, NAN), Grey Market LEO surplus provider (Lone Star Quartermaster)_________
- In the two lines below, please list any special limitations or potentially lethal drawbacks to hiring you.
- _____________________________________________________________
- _____________________________________________________________
- Thank you for filling out an application with Fixernet. You will be alerted by secure comm if a team has decided to hire you.
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