Instructions to the Applicant

The information you provide in this application will be used in the background investigation to assist in determining your suitability for the position of San Andreas Peace Officer, in accordance with POST Commission Regulation 1953.

• It is your responsibility to complete this form and provide all required information.
  
  
• This document must be filled out electronically and printed.
  
  
• You must respond to all items and questions. If a question does not apply to you, write “D.N.A.” (does not apply) in the space provided for your response.
  
  
• Send the completed form to your background investigator or the agency to which you are applying. Do NOT send the form to POST.

Disqualification

There are very few automatic bases for rejection. Even issues of prior misconduct, such as prior illegal drug use, driving under the influence, theft, or even arrest or conviction are usually not, in and of themselves, automatically disqualifying. However, deliberate misstatements or omissions can and often will result in your application being rejected, regardless of the nature or reason for the misstatements/omissions. In fact, the number one reason individuals “fail” background investigations is because they deliberately withhold or misrepresent job-relevant information from their prospective employer.

1. FIRST NAME

• Martina

2. MIDDLE NAME

• Luciana

3. LAST NAME

• González

4. DATE OF BIRTH

• Month: 09
  Date: 06
  Year: 1995

5. PLACE OF BIRTH

• Paleto Bay

6. GENDER

• [—] Male
  Female
  [—] Other

7. RACE

• [—] White
  [—] Black or African American
  Hispanic or Latino
  [—] American Indian or Alaska Native
  [—] Asian
  [—] Flippino American
  [—] Native Hawaiian or Other Pacific Islander
  [—] None of the Above
  [—] Two or More Races

8. HEIGHT

• In feet: 5
  In inches: 7

9. WEIGHT

• In pounds: 165

10. MARITAL STATUS

• Single
  [—] Married
  [—] Divorced
  [—] Widow
  [—] Legally Separated
  [—] Unknown/Not Applicable

11. ADDRESS OF PRIMARY RESIDENCY

• Street Number & Name: Pink Cage Motel Room 5B, Hawick Avenue
  City: Los Santos
  State: San Andreas
  Zip: 80715

12. PRIMARY PHONE NUMBER

• 72848789

13. EMAIL ADDREESS

• [email protected]

14. LEVEL OF EDUCATION

• [—] Some High School
  [—] High School
  [—] Some College
  [—] Technical College
  [—] Associate's Degree
  Bachelor's Degree
  [—] Master's Degree
  [—] Doctorate

15. SCHOOL OF ATTENDANCE

• School Name: University Of Los Santos
  Enrollment Term: 09/07/2011 to 07/23/2013
  Course of Study: Answer Here

16. FIRST PLACE OF EMPLOYMENT

• Company/Agency Name: The Bean Machine
  Position: Barista
  Duties Summary: Making different types of coffee's and other hot/cold drinks, serving customers, cleaning tables, basic stock work
  Employment Term: 03/21/2012 to 09/06/2013
  Reason for Leaving: Graduated University.

17. SECOND PLACE OF EMPLOYMENT

• Company/Agency Name: Thomas & Gabriel advice
  Position: Administrator
  Duties Summary: Talking to public, interacting and giving advice to intentionally venerable people. Helping victims of domestic abuse/honour crimes.
  Employment Term: 01/04/2014 to 08/17/2022
  Reason for Leaving: Pursuing other career paths.

18. THIRD PLACE OF EMPLOYMENT

• Company/Agency Name: D.N.A
  Position: D.N.A
  Duties Summary: D.N.A
  Employment Term: D.N.A
  Reason for Leaving: D.N.A

19. I HAVE A VALID SAN ANDREAS DRIVER LICENSE

• Yes
  [—] No
  [—] Unknown
  [—] Not Willing to Answer
  [—] Other

20. I AM LEGALLY ABLE TO WORK IN THE UNITED STATES OF AMERICA

• Yes
  [—] No
  [—] Unknown
  [—] Not Willing to Answer
  [—] Other

21. I HEARD ABOUT THIS POSITION THROUGH

• [—] LSSD Website
  [—] Sheriff's Station Website
  [—] Social Media
  [—] College Campus
  [—] Career Fair or Seminar
  [—] LSSD Employee
  LS County Employee
  [—] Family Member
  [—] Friends or Neighbors
  [—] Radio
  [—] Billboard
  [—] Other

22. IN ADDITION TO ENGLISH, I KNOW THE FOLLOWING LANGUAGE(S)

• D.N.A

23. I AM A PERSON WITH A DISABILITY

• [—] Yes
  No
  [—] Unknown
  [—] Not Willing to Answer
  [—] Other

24. I AM A CURRENT OR FORMER MEMBER OF THE UNITED STATES MILITARY

• [—] Yes, I currently serve
  • I currently serve in the: D.N.A
  [—] Yes, I have formerly served
  • I have formerly served in the: D.N.A
  No
  [—] Unknown
  [—] Not Willing to Answer
  [—] Other

25. I AM CURRENTLY ON CRIMINAL PROBATION OR PAROLE

• [—] Yes
  No
  [—] Unknown
  [—] Not Willing to Answer
  [—] Other

26. I HAVE PRIOR CONVICTIONS FOR DRIVING UNDER THE INFLUENCE OF ALCOHOL OR OTHER INTOXICANTS IN SAN ANDREAS AND/OR ANOTHER STATE

• [—] Yes
  • Indicate which state(s) and year(s) convicted: Answer Here
  No
  [—] Unknown
  [—] Not Willing to Answer
  [—] Other

27. I HAVE PREVIOUSLY USED MARIJUANA WITHIN THE LAST YEAR

• [—] Yes
  • Indicate the previous month(s) and year(s) you have used marijuana: D.N.A
  No
  [—] Unknown
  [—] Not Willing to Answer
  [—] Other

28. I HAVE PREVIOUSLY USED OTHER ILLEGAL SUBSTANCES WITHIN THE PAST YEAR

• [—] Yes
  No
  [—] Unknown
  [—] Not Willing to Answer
  [—] Other

29. I HAVE COMMITTED THEFT, OR HAVE EMBEZZLED, AN AMOUNT AT LEAST $950.00

• [—] Yes
  No
  [—] Unknown
  [—] Not Willing to Answer
  [—] Other

I, the undersigned, do herein agree that the information aforementioned is true and complete to the best of my knowledge under the penalty of perjury. I further agree and understand that the information provided will be utilized by the Los Santos County Sheriff's Department for the purposes of employment & preliminary background investigation for the position of Deputy Sheriff Trainee. I further understand that the Los Santos County Sheriff's Department employs candidates with no regard to race, religion, sexual orientation, creed, ethnicity, veteran status, or disability. I agree that if selected to move forward with the hiring process, I will abide by the hiring standards as prescribed by the Sheriff of Los Santos County and his designated deputies.

30. SIGNATURE

• M.GONZALEZ

31. DATE

• Month: 09
  Date: 10
  Year: 2022

32. MY TIMEZONE

• BST

33. MY USER CONTROL PANEL USERNAME

• csx47

34. MY UNEDITED SCREENSHOT OF MY USER CONTROL PANEL ADMINISTRATIVE RECORD

• 

35. MY GTAWORLD FORUM ACCOUNT

• ACCESS

36. MY DOUBLE FACTION PERMISSIONS

• ACCESS

37. I CURRENTLY POSSESS A WORKING MICROPHONE, AND I CAN USE TEAMSPEAK 3

• Yes
  [—] No
  [—] No, I have received an exemption from Legal Faction Management

38. HAVE YOU EVER BEEN DISCHARGED OR BANNED FROM A LEGAL FACTION? IF SO, ELABORATE

• [—] Yes
  • Elaboration: Answer Here
  No

39. DO YOU CONSENT TO YOUR CHARACTER ICLY PROVIDING FINGERPRINT SAMPLES AND A MUGSHOT AS PART OF THE APPLICATION PROCESS?

• Yes
  [—] No

40. ATTACH AN IMAGE OF YOUR CHARACTER FROM THE SHOULDERS UP CLEARLY SHOWING THEIR FACE WITH NOTHING COVERING THE FACE

• SPOILER: show

  

DOUBLE FACTION PERMISSION REQUEST
LOS SANTOS COUNTY SHERIFF'S DEPARTMENT

DOUBLE FACTION PERMISSION REQUEST
LOS SANTOS COUNTY SHERIFF'S DEPARTMENT