Axel Fielder - Employment application

1 by Jeremiah Fletcher
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DEPARTMENT OF CORRECTIONS
OFFICE OF PEACE OFFICER SELECTION AND EMPLOYEE DEVELOPMENT
COVER SHEET
STATE OF SAN ANDREAS
PERSONAL HISTORY STATEMENT
SADCR 1902 (Rev. 06/19)
PERSONAL HISTORY STATEMENT
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A. PERSONAL INFORMATION
  • A1. First Name: Axel
    A2. Middle Name:
    A3. Last Name: Fielder

    A4. Date of Birth: 03.02.2004
    A5. Place of Birth: Los Santos

    A6. Gender: [x] Male [-] Female
    A7. Ethnicity: [x] Caucasian [-] African American [-] Hispanic [-] Middle Eastern [-] Asian [-] Other
    A8. Physical Description:
    • Height: 6' 5''
      Weight: 200 lbs
      Hair Color: Brown
      Eye Color: Brown
    A9. Legal Address: 1451 Fountain Avenue, Downtown Los Santos, Los Santos 206, San Andreas
    A10. Contact Number: 2546789
    A11. Contact Email: [email protected]

    A12. Citizenship: [X] U.S. Citizen [-] Naturalized citizen [-] Legal alien [-] U.S. citizenship applicant [-] None of the above

    A13. Languages spoken: [X] English [-] Spanish [-] Japanese [-] Chinese [-] Russian [-] Korean [-] Vietnamese [-] Arabic [-] Other: Specify
B. LICENSE INFORMATION
  • B1. Licenses possessed: [X] Driver's License [-] License to Purchase a Firearm (PF License) [-] License to Carry a Concealed Weapon (CCW License)

    B2. Have any of the above licenses ever been suspended and/or revoked? [-] Yes [X] No
    B3. If yes, please explain:
C. EDUCATION
  • List your level of education and any educational institution you have attended in the forms below, including high schools, colleges, and universities. If more space is required, attach additional forms as necessary.

    C1. Check the boxes if you meet the requirements: [-] General Education Diploma [X] High School Diploma [-] Associate's Degree [-] Bachelor's Degree [-] Master's Degree [-] Doctorate

    C2. List of High School(s) attended:
    • Name of High School: Crenshaw High School
      Address: 213, Crenshaw Avenue, Los Santos, Los Santos 206, San Andreas
      Highest Grade Completed: 12th
    C3. List of Colleges and Universities attended:
    • Name of College/University: DNA
      Address: DNA
      Type of Degree: DNA
      Major / Area of Study: DNA
D. EXPERIENCE AND EMPLOYMENT
  • D1. Employment History: List all previous employment you have had in the forms below, including self-employment, part-time and full-time jobs, temporary and volunteer work and internships. If more space is required, attach additional forms as necessary.
    • Company Name: Clunkin Bell Willowfield.
      Job Title / Rank: Clunkin' Bell resturant assistant manager.
      Reason for leaving: I've left the company because there were too many shootouts in willowfield at the time. I could risk it anymore. Plus, the clunkin' bells franchise manager have told me that they might be closing the willowfield resturant.
    D2. Have you ever been disciplined at work? [-] Yes [X] No
    D3. If yes, please explain:

    D4. Military Service: List your military experience, including service branch, military occupational specialty (MOS) code and type of discharge received upon separation from the armed forces. If more space is required, attach additional forms as necessary.
    • Have you served in the United States Armed Forces?: [-] Yes [X] No
      Branch: Army / Marines / Navy / Air Force / Coast Guard
      Military Occupational Specialty Code:
      Type of Discharge:
    D5. Law Enforcement Experience: List any position held within a law enforcement agency, including civilian, non-sworn positions, and indicate the name of the agency, rank or position held and reason for separation. If more space is required, attach additional forms as necessary.
    • Have you served in a law enforcement agency? [-] Yes [X] No
      Name of agency:
      Rank / Position:
      Reason for leaving:
E. CERTIFICATION
  • I certify that all the information provided by me in connection with my application, whether on this document or not, is true and complete, and I understand that any misstatement, falsification, or omission of information may be grounds for refusal to hire or if hired, termination of employment.

    I understand that as a condition of employment, I will be required to provide legal proof of authorization to work in the U.S.

    I understand that SADCR will check with law enforcement agencies for any criminal history in accordance with applicable statutes.

    I authorize any of the persons or organizations referenced in this application to give you any and all information concerning my previous employment, education, or any other information they might have, personal or otherwise, with regard to any of the subjects covered by this application, and I release all such parties from all liability from any damages which may result from furnishing such information to you.

    This application for employment shall be considered active for a period of time not to exceed 14 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.

    APPLICANT NAME: Axel Fielder
    APPLICANT SIGNATURE: A. Fielder
    DATE: 16/08/2025
(( F. OOC INFORMATION ))
  • F1. Timezone: GMT +2

    F2. Screenshot of the in-game statistics (/stats) of the character you are applying with: ACCESS

    F3. List of all current characters and past character names, current levels and name of current faction:
    Spoiler: show
    (CURRENT) Jayden Holleran— Level 6 — No Faction.
    char1_previous_name_1
    char1_previous_name_2
    char1_previous_name_3
    Spoiler: show
    (CURRENT) Terrance_Gillard — Level 2 — No Faction.
    char2_previous_name_1
    char2_previous_name_2
    char2_previous_name_3
    F4. List and link of all current and past LSRP forums accounts: F5. List and link of screenshots of admin records for all characters: F6. Have you ever been banned from a legal faction? [-] Yes [X] No
    F7. If yes, fill the form below:
    Spoiler: show
    1. Name Surname — Faction — Date — Reason for ban — Unbanned / Still banned
    2. Name Surname — Faction — Date — Reason for ban — Unbanned / Still banned
    F8. Do you have a microphone? [X] Yes [-] No
    F9. Do you have TeamSpeak 3 and are you prepared to use it? [X] Yes [-] No

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