Post by Takeshi Mori on Apr 6, 2016 17:42:10 GMT
Title:
Personal Information
Surname:
Middle Name(s):
Forename:
Sex:
Phone Number:
Address:
Email ((Forum name if none)):
Criminal Record:
Licences
Do you have a Valid Driver's license:
Do possess any other Vehicular/Air Licenses:
Firearm Licenses Possessed:
Tier 1 [ ]
Tier 2 [ ]
Tier 3 [ ]
Former Duffy Corporation Information
Badge number: #
Previous rank(s):
Discharge Date:
Discharge Type:
Discharge Reason:
By signing here I Agree:
Date: DD/MM/YYYY
Signature:
OOC Section
Forum Name:
Hours Played on Character:
Total Hours Played:
Screenshot of recent admin history (/history)(Image No Older than a week):
Notes:
[REINSTATEMENT] (NAME) (DATE)
Personal Information
Surname:
Middle Name(s):
Forename:
Sex:
Phone Number:
Address:
Email ((Forum name if none)):
Criminal Record:
Licences
Do you have a Valid Driver's license:
Do possess any other Vehicular/Air Licenses:
Firearm Licenses Possessed:
Tier 1 [ ]
Tier 2 [ ]
Tier 3 [ ]
Former Duffy Corporation Information
Badge number: #
Previous rank(s):
Discharge Date:
Discharge Type:
Discharge Reason:
By signing here I Agree:
- To allow Duffy Corporation to Conduct Background Checks on myself and my assets to determine if, during the time I was not employed by Duffy Corporation, I have not been convicted of any crimes, be them felonies or misdemeanors and I consent to these checks.
- To allow Duffy Corporation to Conduct Background Checks on my Medical History to determine if during the time I was not employed by Duffy Corporation, I have not sustained any injuries, mental or physical, that prevent me from returning to Duffy Corporation.
- To allow Duffy Corporation to Reinstate me into any Rank they see appropriate.
- To allow Duffy Corporation to Deny my Reinstatement at it's Discretion.
Date: DD/MM/YYYY
Signature:
OOC Section
Forum Name:
Hours Played on Character:
Total Hours Played:
Screenshot of recent admin history (/history)(Image No Older than a week):
Notes:
[b][u]Personal Information[/u][/b]
Surname:
Middle Name(s):
Forename:
Sex:
Phone Number:
Address:
Email ((Forum name if none)):
Criminal Record:
[hr]
[u][b]Licences[/b][/u]
Do you have a Valid Driver's license:
Do possess any other Vehicular/Air Licenses:
Firearm Licenses Possessed:
Tier 1 [ ]
Tier 2 [ ]
Tier 3 [ ]
[hr][b][u]
Former Duffy Corporation Information[/u][/b]
Badge number: #
Previous rank(s):
Discharge Date:
Discharge Type:
Discharge Reason:
[hr]
By signing here I Agree:
[ol type="upper-alpha"][li]To allow Duffy Corporation to Conduct Background Checks on myself and my assets to determine if, during the time I was not employed by Duffy Corporation, I have not been convicted of any crimes, be them felonies or misdemeanors and I consent to these checks.
[/li][li] To allow Duffy Corporation to Conduct Background Checks on my Medical History to determine if during the time I was not employed by Duffy Corporation, I have not sustained any injuries, mental or physical, that prevent me from returning to Duffy Corporation.
[/li][li]To allow Duffy Corporation to Reinstate me into any Rank they see appropriate.[/li][li]To allow Duffy Corporation to Deny my Reinstatement at it's Discretion.[/li][/ol][div][span style="font-size:13.3333px;"]
Date: DD/MM/YYYY
Signature:
[/span][hr]
[b][u]OOC Section[/u][/b]
Forum Name:
Hours Played on Character:
Total Hours Played:
Screenshot of recent admin history (/history)(Image No Older than a week):
Notes:[/div]