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Blueberry Prison Roleplay
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#Post#: 11737--------------------------------------------------
[Medical Branch] Application Format
DIR By: Jose
Date: May 25, 2018, 5:00 am
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Application Title: [Medical Unit Application] Surname, Firstname
Application Format:
[center]
HTML http://i.imgur.com/olA0Iv4.png[/center]
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[center]APPLICANT'S INFORMATION[/center]
1.01) Full Name: ANSWER
1.02) Gender: ANSWER
1.03) Date of Birth: ANSWER
1.04) Current Age: ANSWER
1.05) Phone Number: ANSWER
1.06) Do you have any medical conditions, mental or physical
disabilities? If yes, list them here: ANSWER
1.07) State your current address of residence: ANSWER
2.01) Birthplace: ANSWER
2.02) Are you a legal US citizen: ANSWER
2.03) If not, do you have a valid passport or visa: ANSWER
2.04) Are you able to speak and write English properly?: ANSWER
2.05) Nationality: ANSWER
2.06) Do you speak any other languages aside English? If yes,
please list them here and your skill level in that language:
ANSWER
[center]CRIMINAL RECORD[/center]
3.01) Do you possess a valid driving license?: ANSWER
3.02) Has your license ever been revoked? If yes, when and why?:
ANSWER
3.03) Have you ever been arrested or charged with a crime?:
ANSWER
3.04) Have you ever received a ticket, and if yes for what?:
ANSWER
[center]NARRATIVE INFORMATION[/center]
4.01) Tell us about your self and why you wish to join the
Blueberry Prison Medical Unit (min. 200 words):
4.02) What makes you different from other applicants that may
want the same position (min. 75 words):
[center]ADDITIONAL INFORMATION[/center]
5.01) Have you ever submitted an application to the Medical
Unit before? If yes, when?: ANSWER
5.02) Please list any and all previous employments that you have
been involved with: ANSWER
5.03) Please list any references from friends or previous
employers: ANSWER
5.04) Have you ever served with a other government agency? if
yes, which?: ANSWER
5.05) What was your reason for discharging from the agency?:
ANSWER
[center]OUT OF CHARACTER[/center]
6.01) First Name: ANSWER
6.02) Gender: ANSWER
6.03) Age: ANSWER
6.04) Geographical Location & Timezone: ANSWER
6.05) Time playing BP-RP: ANSWER
6.06) List ALL current and past character names and levels:
ANSWER
7.07) List ALL past faction memberships and your rank within
those factions: ANSWER
7.08) Link a screenshot of your in-game statistics (accessed via
/stats): ANSWER
7.09) Can you communicate effectively and efficiently in the
English language?: ANSWER
7.10) What motivates you to join the Blueberry Prison Medical
Unit? (min.75words): ANSWER
--- Quote ---
> I, Firstname Lastname, hereby consent that any and all
information pertaining to a Criminal Record registered in my
name with the National Repository for Criminal Records in the
United States may be provided to authorized persons at the
Blueberry Prison Medical Unit. I recognize that an employee of
the Blueberry Prison Medical Unit is in a position of trust
within the community and I hereby consent to the Blueberry
Prison Medical Unit performing a background check of my criminal
records. I further agree to absolutely release, discharge and
absolve the Blueberry Prison Medical Unit, the City of Los
Santos and its employees from all claims, losses, or damages
including indirect or consequential, occasioned by me during, or
as a result of any investigation for a Criminal Record.
--- End Quote ---
--- Quote ---
> I, Firstname Lastname, hereby authorize any person, employer,
organization, or physician to provide any information, opinion,
reports, records, documents or copies thereof in any form, which
may be requested in connection with my application for
employment with the Blueberry Prison Medical Unit and any
subsequent training. Personal information about me will be used
to assess my qualifications and suitability in relation to my
application as a police officer as well as research purposes. I
consent to the collection, use, disclosure, transmittal, and
examination of all information compiled by the Blueberry Prison
Medical Unit. I agree to waive any right of action against any
person or organization providing information or opinions in
compliance with this authorization. I hereby acknowledge and
declare the terms of this authorization for release of
information are fully understood by me.
--- End Quote ---
7.01) Applicant's Signature: ANSWER
7.02) Date: MM/DD/YYYY
------------------------------------------------------------------------
--- Code ---
Application Title: [Application] Firstname Lastname
Application Format:
[center]
HTML http://i.imgur.com/olA0Iv4.png[/center]
---------------------------------------------------------
[center]APPLICANT'S INFORMATION[/center]
1.01) Full Name: ANSWER
1.02) Gender: ANSWER
1.03) Date of Birth: ANSWER
1.04) Current Age: ANSWER
1.05) Phone Number: ANSWER
1.06) Do you have any medical conditions, mental or physical
disabilities? If yes, list them here: ANSWER
1.07) State your current address of residence: ANSWER
2.01) Birthplace: ANSWER
2.02) Are you a legal US citizen: ANSWER
2.03) If not, do you have a valid passport or visa: ANSWER
2.04) Are you able to speak and write English properly?:
ANSWER
2.05) Nationality: ANSWER
2.06) Do you speak any other languages aside English? If yes,
please list them here and your skill level in that language:
ANSWER
[center]CRIMINAL RECORD[/center]
3.01) Do you possess a valid driving license?: ANSWER
3.02) Has your license ever been revoked? If yes, when and
why?: ANSWER
3.03) Have you ever been arrested or charged with a crime?:
ANSWER
3.04) Have you ever received a ticket, and if yes for what?:
ANSWER
[center]NARRATIVE INFORMATION[/center]
4.01) Tell us about your self and why you wish to join the
Blueberry Prison Medical Unit (min. 200 words):
4.02) What makes you different from other applicants that may
want the same position (min. 75 words):
[center]ADDITIONAL INFORMATION[/center]
5.01) Have you ever submitted an application to the Medical
Unit before? If yes, when?: ANSWER
5.02) Please list any and all previous employments that you
have been involved with: ANSWER
5.03) Please list any references from friends or previous
employers: ANSWER
5.04) Have you ever served with a other government agency? if
yes, which?: ANSWER
5.05) What was your reason for discharging from the agency?:
ANSWER
[center]OUT OF CHARACTER[/center]
6.01) First Name: ANSWER
6.02) Gender: ANSWER
6.03) Geographical Location & Timezone: ANSWER
6.04) Time playing BP-RP: ANSWER
6.05) List ALL current and past character names and levels:
ANSWER
7.06) List ALL past faction memberships and your rank within
those factions: ANSWER
7.07) Link a screenshot of your in-game statistics (accessed
via /stats): ANSWER
7.08) Can you communicate effectively and efficiently in the
English language?: ANSWER
7.09) What motivates you to join the Blueberry Prison Medical
Unit? (min.75words): ANSWER
--- Quote ---
> I, Firstname Lastname, hereby consent that any and all
information pertaining to a Criminal Record registered in my
name with the National Repository for Criminal Records in the
United States may be provided to authorized persons at the
Blueberry Prison Medical Unit. I recognize that an employee of
the Blueberry Prison Medical Unit is in a position of trust
within the community and I hereby consent to the Blueberry
Prison Medical Unit performing a background check of my criminal
records. I further agree to absolutely release, discharge and
absolve the Blueberry Prison Medical Unit, the City of Los
Santos and its employees from all claims, losses, or damages
including indirect or consequential, occasioned by me during, or
as a result of any investigation for a Criminal Record.
--- End Quote ---
--- Quote ---
> I, Firstname Lastname, hereby authorize any person,
employer, organization, or physician to provide any information,
opinion, reports, records, documents or copies thereof in any
form, which may be requested in connection with my application
for employment with the Blueberry Prison Medical Unit and any
subsequent training. Personal information about me will be used
to assess my qualifications and suitability in relation to my
application as a police officer as well as research purposes. I
consent to the collection, use, disclosure, transmittal, and
examination of all information compiled by the Blueberry Prison
Medical Unit. I agree to waive any right of action against any
person or organization providing information or opinions in
compliance with this authorization. I hereby acknowledge and
declare the terms of this authorization for release of
information are fully understood by me.
--- End Quote ---
7.01) Applicant's Signature: ANSWER
7.02) Date: MM/DD/YYYY
--- End Code ---
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