[AmeriCare] Employment Application Template

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Kevin_Verdum
Posts: 50
Joined: April 12th, 2019, 8:51 pm

[AmeriCare] Employment Application Template

Post by Kevin_Verdum » May 12th, 2020, 3:17 am

To apply for employment with AmeriCare - Ambulance Services, please fill out the following form, and post it HERE. The post subject should be formatted as followed; [Employment Application] Forename Surname.
Image
SECTION I. - Personal information
Please provide accurate personal information in fields A1 through A15 as it's shown on your State-Issued Driver's License or State-Issued Identification Card.
  • A1. Last Name:
    A2. First Name:
    A3. Middle Name:

    A4. Date of Birth: DD/MMM/YYYY
    A5. County of citizenship:

    A6. Contact Number: (555)-
    A7. Contact Email:

    A8. Number / Street:
    A9. City / State:

    A10. Height: 0'0
    A11. Weight: 0 lbs
    A12. Hair Color:
    A13. Eye Color:

    A14. Sex
    • [-] Male
      [-] Female
    A15. Race
    • [-] African American
      [-] Asian
      [-] Filipino
      [-] Pacific Islander
      [-] American Indian
      [-] Caucasian
      [-] Hispanic
      [-] Two or more races
Image
SECTION II. - Educational background
Please provide information as it pertains to your educational background in sections through B1 through B3. 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 of the maximum education achived:
    • [-] Less then High School.
      [-] General Education Diploma.
      [-] High School Diploma.
      [-] Associate's Degree.
      [-] Bachelor's Degree.
      [-] Graduate Degree.
  • B2. Please list High School(s) attended:
    • • Name of High School:
      • City / State of High School:
      • From (MM/YYYY):
      • To (MM/YYYY):

      • Name of High School:
      • City / State of High School:
      • From (MM/YYYY):
      • To (MM/YYYY):
  • B3. Please list University(s) and/or Collage(s) attended:
    • • Name of University/Collage:
      • City / State of University/Collage:
      • From (MM/YYYY):
      • To (MM/YYYY):
      • Area of Study / Major:
      • Degree earned?:
      • If yes, type of degree:

      • Name of University/Collage:
      • City / State of University/Collage:
      • From (MM/YYYY):
      • To (MM/YYYY):
      • Area of study / Major:
      • Degree earned?:
      • If yes, type of degree:
Image
SECTION III. - Previous employment
In fields C1 through C3 please provide any pertinent past employment information that can be verified through contact with the company, or other means necessary.
  • C1. Previous employment and work experience:
    • • Name of the Company:
      • Job Title / Position:
      • City / State of Company:
      • From (MM/YYYY):
      • To (MM/YYYY):
      • Type of Employment:
      • [-] Full-Time
        [-] Part-Time
        [-] Self-Employed
        [-] Volunteer
      • Name of the Company:
      • Job Title / Position:
      • City / State of Company:
      • From (MM/YYYY):
      • To (MM/YYYY):
      • Type of Employment:
      • [-] Full-Time
        [-] Part-Time
        [-] Self-Employed
        [-] Volunteer
    C2. If you have served in the military, please indicate which branch:
    • [-] United States Army
      [-] United States Navy
      [-] United States Air Force
      [-] United States Marine Corp
      [-] United States Coast Guard
      [-] United States National Guard
      [-] Reserves Corp
      [-] Other military branch(es)
    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
SECTION IV. - Criminal and Legal history
In fields D1 through D3 please provide any past criminal or civil charges that have been filed against you, also provide information about your current non-expired and non-suspended licenses.
  • D1. Have you ever been placed under arrest, under investigation for a certain felony; misdemeanor offenses either civil or criminal?:
    • [-] Yes
      [-] No
    • If yes, please explain further:
      • • Charge:
        • Arresting Agency:
        • Date (MM/YYYY):
        • City / State:

        • Charge:
        • Arresting Agency:
        • Date (MM/YYYY):
        • City / State:
  • D2. Do you have an unexpired valid driver's license in the State of San Andreas?
    • [-] Yes
      [-] No
  • D3. Do you have an unexpired valid NREMT certification in the State of San Andreas?
    • [-] Yes
      [-] No

Image
SECTION V - 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 of an appointment has been made.

Applicant's signature: Firstname Lastname
((SECTION VI - Out of character Information ))
  • E1. Real-Life Name (Optional):
    E2. Real-Life Age (Optional):
    E3. Real-Life Country of Origin / Residence:

    E4. LS-RP Forum Account Profile Link: ACCESS
    E5. How long have you played on the server?:
  • E5. List all current and past character names, on every account, and their levels:
    • • 1)
      • 2)
      • 3)
      • 4)
      • 5)
  • E6. Link an unedited screenshot of your admin record for all your characters on every account:
    • • 1)
      • 2)
      • 3)
      • 4)
      • 5)
  • E7. Have you been admin jailed or banned in the past three (3) months?
    • [-] Yes
      [-] No

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/Tz9pvBB.png[/img][/center]
[line][/line]
[center][b][size=150]SECTION I. - Personal information[/size][/b][/center]
[line][/line]
[size=60][center]Please provide accurate personal information in fields A1 through A15 as it's shown on your State-Issued Driver's License or State-Issued Identification Card.[/center][/size]
[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] County of citizenship:

[b]A6.[/b] Contact Number: (555)-
[b]A7.[/b] Contact Email:

[b]A8.[/b] Number / Street:
[b]A9.[/b] City / State:

[b]A10.[/b] Height: 0'0
[b]A11.[/b] Weight: 0 lbs
[b]A12.[/b] Hair Color:
[b]A13.[/b] Eye Color:

[b]A14.[/b] Sex
[list=none][-] Male
[-] Female
[/list]

[b]A15.[/b] Race
[list=none][-] African American
[-] Asian
[-] Filipino
[-] Pacific Islander
[-] American Indian
[-] Caucasian
[-] Hispanic
[-] Two or more races
[/list]

[/divbox]
[divbox=white][center][img]https://i.imgur.com/Tz9pvBB.png[/img][/center]
[line][/line]
[center][b][size=150]SECTION II. - Educational background[/size][/b][/center]
[line][/line]
[size=60][center]Please provide information as it pertains to your educational background in sections through B1 through B3. All applicants must at least have a High-school Diploma, or a General Education Diploma (GED) to be considered for employment.[/center][/size]
[hr]
[list=none][b]B1.[/B] Please check the boxes of the maximum education achived:
[list=none][-] Less then High School.
[-] General Education Diploma.
[-] High School Diploma.
[-] Associate's Degree.
[-] Bachelor's Degree.
[-] Graduate Degree.
[/list][/list]

[list=none][b]B2.[/B] Please list High School(s) attended:
[list=none]• Name of High School:
• City / State of High School:
• From (MM/YYYY):
• To (MM/YYYY):

• Name of High School:
• City / State of High School:
• From (MM/YYYY):
• To (MM/YYYY):
[/list][/list]

[list=none][b]B3.[/B] Please list University(s) and/or Collage(s) attended:
[list=none]• Name of University/Collage:
• City / State of University/Collage:
• From (MM/YYYY):
• To (MM/YYYY):
• Area of Study / Major:
• Degree earned?:
• If yes, type of degree:

• Name of University/Collage:
• City / State of University/Collage:
• From (MM/YYYY):
• To (MM/YYYY):
• Area of study / Major:
• Degree earned?:
• If yes, type of degree:

[/divbox][divbox=white][center][img]https://i.imgur.com/Tz9pvBB.png[/img][/center]
[line][/line]
[center][b][size=150]SECTION III.  - Previous employment[/size][/b][/center]
[line][/line]
[size=60][center]In fields C1 through C3 please provide any pertinent past employment information that can be verified through contact with the company, or other means necessary.[/center][/size]
[hr]
[list=none][b]C1.[/B] Previous employment and work experience:
[list=none]• Name of the Company:
• Job Title / Position:
• City / State of Company:
• From (MM/YYYY):
• To (MM/YYYY):
• Type of Employment:
[list=none][-] Full-Time
[-] Part-Time
[-] Self-Employed
[-] Volunteer
[/list]

• Name of the Company:
• Job Title / Position:
• City / State of Company:
• From (MM/YYYY):
• To (MM/YYYY):
• Type of Employment:
[list=none][-] Full-Time
[-] Part-Time
[-] Self-Employed
[-] Volunteer
[/list]
[/list]
[b]C2.[/B] If you have served in the military, please indicate which branch:
[list=none][-] United States Army
[-] United States Navy
[-] United States Air Force
[-] United States Marine Corp
[-] United States Coast Guard
[-] United States National Guard
[-] Reserves Corp
[-] Other military branch(es) 
[/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][/list]
[hr]

[/divbox][divbox=white][center][img]https://i.imgur.com/Tz9pvBB.png[/img][/center]
[line][/line]
[center][b][size=150]SECTION IV.  - Criminal and Legal history[/size][/b][/center]
[line][/line]
[size=60][center]In fields D1 through D3 please provide any past criminal or civil charges that have been filed against you, also provide information about your current non-expired and non-suspended licenses.[/center][/size]
[hr]
[list=none][b]D1.[/B] Have you ever been placed under arrest, under investigation for a certain felony; misdemeanor offenses either civil or criminal?:
[list=none][-] Yes
[-] No
[/list][/list]
[list=none][list=none]If yes, please explain further:
[list=none]• Charge:
• Arresting Agency:
• Date (MM/YYYY):
• City / State:

• Charge:
• Arresting Agency:
• Date (MM/YYYY):
• City / State:
[/list][/list][/list]
[list=none][b]D2.[/B] Do you have an unexpired valid driver's license in the State of San Andreas?
[list=none][-] Yes
[-] No
[/list][/list]
[list=none][b]D3.[/B] Do you have an unexpired valid NREMT certification in the State of San Andreas?
[list=none][-] Yes
[-] No
[/list]
[hr]

[/divbox][divbox=white][center][img]https://i.imgur.com/Tz9pvBB.png[/img][/center]
[line][/line]
[center][b][size=150]SECTION V - Certification and Declerations[/size][/b][/center]
[line][/line]
[size=60][center]Please read and sign the declaration and certification at the bottom of the application.[/size][/center]
[line][/line]

[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 of an appointment has been made.[/i]

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

[list=none][b]E1.[/B] Real-Life Name (Optional):
[b]E2.[/B] Real-Life Age (Optional):
[b]E3.[/B] Real-Life Country of Origin / Residence:

[b]E4.[/B] LS-RP Forum Account Profile Link: [url=]ACCESS[/url]
[b]E5.[/B] How long have you played on the server?:
[/list]

[list=none][b]E5.[/B] List all current and past character names, on every account, and their levels:
[list=none]• 1)
• 2)
• 3)
• 4)
• 5)
[/list][/list]
[list=none][b]E6.[/B] Link an unedited screenshot of your admin record for all your characters on every account:
[list=none]• 1)
• 2)
• 3)
• 4)
• 5)
[/list][/list]

[list=none][b]E7.[/B] Have you been admin jailed or banned in the past [b]three (3) months[/b]?
[list=none][-] Yes
[-] No
[/list][/list]
[line][/line]
[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:
[/divbox]
Image CHIEF OF OPERATIONS KEVIN VERDUM Executive Manager, Los Santos County Field Office   AmeriCare - Ambulance Services — "Speed when it Matters"

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