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  1. [divbox=#f7f7f7][center][img]http://i.imgur.com/rij6lkE.png[/img]
  2. [size=100]LOS SANTOS POLICE DEPARTMENT[/size]
  3. [b][size=130]PRELIMINARY BACKGROUND APPLICATION[/size][/b][/center]
  4.  
  5. [hr][/hr]
  6. [img]http://i.imgur.com/dWeOJaG.png[/img] [u][size=160]1. PERSONAL INFORMATION[/size][/u]
  7.  
  8. [list]
  9. [size=95][u](( IN CHARACTER ))[/u][/size]
  10.  
  11. [b][u]1.1[/u][/b] Title: Mr
  12. [b][u]1.2[/u][/b] Surname: Cotton
  13. [b][u]1.3[/u][/b] Forename: Matt
  14. [b][u]1.4[/u][/b] Gender: Male
  15. [b][u]1.5[/u][/b] Age: 29
  16. [b][u]1.6[/u][/b] Date of Birth: 14/APR/1987
  17. [b][u]1.7[/u][/b] Race: African-American
  18.  
  19. [b][u]1.8[/u][/b] Phone Number: 1461549
  20.  
  21. [b][u]1.9[/u][/b] Place of Birth: Jefferson, San Andreas
  22. [b][u]1.10[/u][/b] Place of Residence: Elm Street, East Los Santos, Los Santos, San Andreas
  23.  
  24. [b][u]1.10.1[/u][/b] Proof of Residence: [url=http://i.imgur.com/3ixilOT.jpg]ACCESS[/url]
  25. [b][u]1.11.1[/u][/b] Do you have any medical conditions, mental or physical disabilities? No
  26. [b][u]1.11.2[/u][/b] If yes, please list them here: N/A
  27.  
  28. [size=95][u](( OUT OF CHARACTER ))[/u][/size]
  29.  
  30. [b][u]1.12[/u][/b] Forename (OOC): James
  31. [b][u]1.13[/u][/b] Gender (OOC): Male
  32. [b][u]1.14[/u][/b] In-game level (OOC): 19
  33. [b][u]1.15[/u][/b] Age (OOC): 18
  34. [b][u]1.16[/u][/b] Geographical location (OOC): Athens, Greece
  35.  
  36. [b][u]1.17[/u][/b] Time playing LSRP (OOC): 5 years
  37. [b][u]1.18[/u][/b] Time playing SAMP (OOC): 6.5 years
  38.  
  39. [b][u]1.19[/u][/b] List ALL current and past character names (all previous characters you have used go in the spoilers below) and their levels ([url=https://dl.dropboxusercontent.com/u/6269935/LSPD/Recruitment%20%26%20Employment/PBA119.png]example[/url]) (OOC):
  40. [altspoiler=Matt Cotton, Level 19]Alejandro Nunez #1
  41. Galeno Rosales #2
  42. Alejandro Nunez #3
  43. Danny_Milani #4
  44. Chieko_Tanaka #5
  45. Chieko_Takana #6
  46. Chiko_Tanaka #7
  47. Chieko_Tanaca #8
  48. Chieko_Nakano #9
  49. Chieko_Wakahisa #10
  50. Chieko_Wakahissa #11
  51. Chieko_Wakachissa #12
  52. Lisandro_Delgadillo #13
  53. Chieko_Wakachissa #14
  54. Lisandro_Delgadillo #15
  55. Lisandro_Ochoa #16
  56. Galeno Milani #17
  57. Chieko_Wakackhissa #18
  58. Lisandro_Serna #19[/altspoiler]
  59. [altspoiler=Antonio Feratti, Level 6]Russell_Hamilton #1
  60. William_Jarnigan #2[/altspoiler]
  61. [altspoiler=Lisandro_Rosales, Level 3]No past names[/altspoiler]
  62. [altspoiler=Joseph_Civella, Level 8]Ireneo_Bergamaschi #1
  63. Joseph_Civella #2
  64. Thomas_Roleson #3[/altspoiler]
  65. [b][u]1.20[/u][/b] List ALL past faction memberships and your rank within those factions (OOC):
  66. The D'Aquilla Crime Family - Associate
  67. The Thieves - Leader
  68. LSPD - Police Officer II
  69. SASD - Deputy Sheriff Generalist
  70. [b][u]1.20.1[/u][/b] If you were in the LSPD before state the date when you resigned or were terminated (IC/OOC):
  71. November 20th, 2015
  72. [b][u]1.20.2[/u][/b] If you were in the LSPD before then post a link to your Reinstatement request where you were authorized to go through Recruitment (IC/OOC): [url=http://pd.lsgov.us/forum/viewtopic.php?f=855&t=190838&p=1302056#p1302056]Reinstatement request[/url]
  73.  
  74. [b][u]1.21.1[/u][/b] Are you currently in an official OR unofficial faction with another account, if yes, which faction? (OOC): No
  75. [b][u]1.21.2[/u][/b] If official, post a link to your double factions approval from PD's side (Refer to rule 9) (OOC): N/A
  76.  
  77. [b][u]1.22.1[/u][/b] LS-RP Forum account (OOC): [url=https://forum.ls-rp.com/memberlist.php?mode=viewprofile&u=203242]SurSide[/url]
  78. [b][u]1.22.2[/u][/b] LS-RP Forum account confirmation (OOC): [url=https://forum.ls-rp.com/viewtopic.php?f=21&t=235770&p=7515695#p7515695]Account confirmation[/url]
  79.  
  80. [size=95][u](( SCREENSHOTS ))[/u][/size]
  81.  
  82. [b][u]1.23[/u][/b] Link a unedited screenshot of your admin record for ALL your accounts (OOC):
  83. [spoiler][url=https://i.gyazo.com/18484524162d3aaeca5fc4bdae3e6c65.png]Image 1[/url]
  84. [url=https://i.gyazo.com/fda05ee05f867ca1d2a7b4bd0d1e753c.png]Image 2[/url]
  85. [url=https://i.gyazo.com/0849eedbf6fa5e8193c2c1a16dfcfda3.png]Image 3[/url]
  86. [url=https://i.gyazo.com/e6b3211b5bf4726fa73314ae99ca1b4c.png]Image 4[/url]
  87. (Remove the above as necessary)[/spoiler]
  88.  
  89. [b][u]1.24[/u][/b] Link a unedited screenshot of your in-game statistics (accessed via /stats) for ALL accounts (OOC):
  90. [spoiler][url=http://i.imgur.com/zex7XQM.jpg]Image 1[/url]
  91. [url=http://i.imgur.com/WsfMsW0.jpg]Image 2[/url]
  92. [url=http://i.imgur.com/SaZvaqo.jpg]Image 3[/url]
  93. [url=http://i.imgur.com/Lv47r0M.jpg]Image 4[/url]
  94. (Remove the above as necessary)[/spoiler]
  95. [/list]
  96.  
  97. [hr][/hr]
  98. [img]http://i.imgur.com/dWeOJaG.png[/img] [u][size=160]2. LANGUAGE PROFICIENCY[/u][/size]
  99.  
  100. [list]
  101. [size=95][u](( IN CHARACTER ))[/u][/size]
  102.  
  103. [b][u]2.1[/u][/b] Can you communicate effectively and efficiently in the English language? Yes
  104.  
  105. [b][u]2.2.1[/u][/b] Do you speak any other languages aside English? Yes
  106. [b][u]2.2.2[/u][/b] If yes, please list them here and your skill level in that language:
  107. French, Spanish
  108.  
  109. French - B1 certificate
  110. Spanish - A2 certificate
  111.  
  112. [size=95][u](( OUT OF CHARACTER ))[/u][/size]
  113.  
  114. [b][u]2.3[/u][/b] Can you communicate effectively and efficiently in the English language? (OOC): Yes
  115.  
  116. [b][u]2.4.1[/u][/b] Do you speak any other languages aside English? (OOC): Yes
  117. [b][u]2.4.2[/u][/b] If yes, please list them here and your skill level in that language (OOC):
  118. Greek, French, Spanish
  119.  
  120. Greek - Native language
  121. French - B2 certificate
  122. Spanish - A2 certificate
  123.  
  124. [b][u]2.5[/u][/b] Are you able to function efficiently and effectively in a Teamspeak (VOIP) environment? (OOC): Yes
  125. [b][u]2.6[/u][/b] Do you possess a working microphone? (OOC): Yes
  126. [/list]
  127.  
  128. [hr][/hr]
  129. [img]http://i.imgur.com/dWeOJaG.png[/img] [u][size=160]3. LICENSES AND PERMITS[/u][/size]
  130.  
  131. [list]
  132. [size=95][u](( IN CHARACTER ))[/u][/size]
  133.  
  134. [b][u]3.1.1[/u][/b] Do you possess a valid San Andreas driving license? - Yes
  135. [b][u]3.1.2[/u][/b] If yes, do you possess any warnings on your license? - No
  136. [b][u]3.1.3[/u][/b] Have or has your drivers license ever been revoked? - No
  137.  
  138. [b][u]3.2.1[/u][/b] Do you possess a valid aviation license? - No
  139. [b][u]3.2.2[/u][/b] Have or has your aviation license ever been revoked? - No
  140.  
  141. [b][u]3.3.1[/u][/b] Do you possess a valid firearms license? - No
  142. [b][u]3.3.2[/u][/b] If yes, please provide a direct link to your accepted firearms application (If multiple, link each one separately): N/A
  143. [b][u]3.3.3[/u][/b] Have or has your firearms license ever been revoked? - No
  144.  
  145. [b][u]3.4.1[/u][/b] Do you posess a valid medical license (BLS/ILS)? - No
  146. [b][u]3.4.2[/u][/b] If yes, please provide photo evidence of your medical license: N/A
  147. [b][u]3.4.3[/u][/b] Have or has your medical license ever been revoked? - No
  148. [/list]
  149.  
  150. [hr][/hr]
  151. [img]http://i.imgur.com/dWeOJaG.png[/img] [u][size=160]4. EXPERIENCE AND EMPLOYMENT[/u][/size]
  152.  
  153. [list]
  154. [size=95][u](( IN CHARACTER ))[/u][/size]
  155.  
  156. Experience and Employment includes establishments or organisations you may have worked for, for voluntary or profitable purposes and should be separated below appropriately, with more fields implemented if required;
  157.  
  158. Name of Company: Los Santos Police Department
  159. Nature of Work: Police Officer
  160. Reason for Dismissal: Resignation
  161. Employer, if applicable: Los Santos Government
  162. Rank, if applicable: Police Officer II
  163. Position, if applicable: Police Officer
  164.  
  165. Name of Company: Idlewood Gas Station 24/7
  166. Nature of Work: Management
  167. Reason for Dismissal: Business has been sold
  168. Employer, if applicable: Myself
  169. Rank, if applicable: CEO
  170. Position, if applicable: CEO
  171. [/list]
  172.  
  173. [hr][/hr]
  174. [img]http://i.imgur.com/dWeOJaG.png[/img] [u][size=160]5. CRIMINAL AND CITATION RECORD[/u][/size]
  175.  
  176. [list]
  177. [size=95][u](( IN CHARACTER ))[/u][/size]
  178.  
  179. Criminal and Citation Record includes encounters with the law, from a citation (e.g. vehicle ticket, etc) to a felony (e.g. evading a peace officer, etc), if you were arrested or if you were charged, all separated below appropriately, with more fields implemented if required;
  180.  
  181. Nature of Sentence: N/A
  182. Date of Sentence: N/A
  183. Time served, if applicable: N/A
  184.  
  185. Nature of Citation: N/A
  186. Issue Date of Citation: N/A
  187. Amount paid, if available: N/A
  188. [/list]
  189.  
  190. [hr][/hr]
  191. [img]http://i.imgur.com/dWeOJaG.png[/img] [u][size=160]6. REFERENCES AND RECOMMENDATIONS[/u][/size]
  192.  
  193. [list]
  194. [size=95][u](( IN CHARACTER / OUT OF CHARACTER ))[/u][/size]
  195.  
  196. References and Recommendations may be given from any current serving employee of the Los Santos Police Department, and should be separated below appropriately, with more fields implemented if required;
  197.  
  198. [quote]
  199. Employee's full name: N/A
  200. Employee's current rank: N/A
  201. Employee's reference: N/A
  202. [/quote]
  203. [quote]
  204. (( Employee's full name: Tanisha Jordan
  205. Employee's current rank: Police Officer II
  206. Employee's reference: I've had quite some roleplay experience with James not too long ago and it for sure was memorable. He is a great player and an amazing person, indeed will be a good addition to the faction.))
  207. [/quote]
  208. [/list]
  209.  
  210. [hr][/hr]
  211. [img]http://i.imgur.com/dWeOJaG.png[/img] [u][size=160]7. APPLICANTS DECLARATION[/u][/size]
  212.  
  213. [list]
  214. [size=95][u](( IN CHARACTER ))[/u][/size]
  215. [quote][size=85]I certify that the answers contained within this Personal Background Application are true and complete to the best of my knowledge. By agreeing below I hereby authorize investigation of all statements contained within this application for employment as may be necessary in arriving at an employment decision. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee from the recruitment process at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. In the event of employment, I understand that any false or misleading information given in my application or interview(s) may result in denial and bar from re-application. I understand, also, that I am required to abide by all rules and regulations of the employer.[/size][/quote]
  216. [b][u]7.1[/u][/b] Do you understand and agree to the above declaration: Yes
  217.  
  218. [size=95][u](( OUT OF CHARACTER ))[/u][/size]
  219. [quote][size=85]By submitting this Personal Background Application I acknowledge that I have not been banned from applying for the LSPD and am in good standing with the LSPD. I understand and accept the fact that if proved any OOC lying has taken place in my submitted application that I am responsible and will face admin disciplinary action for OOC lying in a formal application with deceit. I hereby claim that nothing in this application is submitted to be false or of a deceitful nature and everything aforementioned in this application is of 100% accuracy and honesty. I take full responsibility for any recruitment policy violation.
  220.  
  221. I understand the LSPD and its subordinates (Recruitment officers and Training Officers) have every right to OOC deny my application, or ban me from applying for whatever reason(s), without reason or justification. I also agree that any attempt to transfer over to another law enforcement or government faction has to be agreed upon by the faction leader of the LSPD before it takes place. I understand that this application is of an at will relationship and will abide by all recruitment policies.[/size][/quote]
  222. [b][u]7.2[/u][/b] Do you agree to adhere and understand the above declaration (OOC): Yes
  223. [/list]
  224.  
  225. [hr][/hr]
  226. [img]http://i.imgur.com/dWeOJaG.png[/img] [u][size=160]8. (( ADDITIONAL INFORMATION OR CONCERNS ))[/u][/size]
  227.  
  228. [list]
  229. [/list]
  230. [hr][/hr][/divbox]
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