[FORM] Application

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Aurora Farace
Site Admin
Posts: 29
Joined: Fri Mar 15, 2024 2:07 pm


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I. PERSONAL INFORMATION


  • Title:
    • [] Mr.
    • [] Ms.
    • [] Mrs.
    • [] Dr.
    • [] Mx.
    • [] Other: (state what here)

    Full Name:
    ANSWER

    Date of Birth:
    DD/MMM/YYYY


    Gender:
    • [] Male
    • [] Female
    • [] Other: (state what here)

    Race:
    ANSWER

    Home Address:
    ANSWER

    Phone Number:
    ANSWER

    Email Address:
    ANSWER (( Include your GTA World forum name here. ))




II. EDUCATION AND TRAINING


If applying for a position other than physician/psychiatrist, only fill out the medical degree part and delete the rest of the code under this section.
  • Position Applying For:
    • [] Physician
    • [] Psychiatrist
    • [] Nurse
    • [] Therapist
    • [] Volunteer
  • Medical Degree:
    • University Name:
      ANSWER

    • Degree Earned:
      ANSWER

    • Graduation Year:
      ANSWER

    • Honors or Distinctions: (optional)
      ANSWER
  • Residency Training:
    • Residency Program:
      ANSWER

    • Specialty:
      ANSWER

    • Location:
      ANSWER

    • Completion Year:
      ANSWER

    • Honors or Distinctions: (optional)
      ANSWER
  • Fellowship Training: (if applicable)
    • Fellowship Program:
      ANSWER

    • Specialty/Subspecialty:
      ANSWER

    • Institution:
      ANSWER

    • Location:
      ANSWER

    • Completion Year:
      ANSWER

    • Honors or Distinctions: (optional)
      ANSWER
  • Relevant Courses or Certifications: (optional)
    List any relevant continuing education courses, workshops, or certifications, including the date completed and issuing organization.
    Link to Medical License Obtained here:

III. PROFESSIONAL EXPERIENCE
Provide information about your last work experience.
  • Job Title:
    ANSWER

    Employer:
    ANSWER

    Location:
    ANSWER

    Dates of Employment:
    DD/MMM/YYYY to DD/MMM/YYYY

    Responsibilities Summary:
    ANSWER

    Key Accomplishments: (optional)
    ANSWER

IV. MOTIVATIONAL LETTER
  • Why do you want to work at Valentines Rehabilitation Center?: (200 words max.)
    Describe your reasons for wanting to join our rehabilitation center here.

(( V. OUT-OF-CHARACTER INFORMATION ))


[/br
Discord Username:
ANSWER

GTA World Forum Account Name & Link:
ANSWER

Unedited Screenshot of UCP Admin Record:
ANSWER

Timezone:
ANSWER

Provide a screenshot of your character's /stats that you're applying with:
ANSWER




Title Template:

Code: Select all

[POSITION] YOUR FULL NAME

Code: Select all

[divbox=#303544][center][br][/br][img]https://i.imgur.com/6WhFHLO.png[/img][br][/br][/center][/divbox][br][/br]
[divbox=#363E54][br][/br][left][color=#47AEBF][size=120][b][indent][center]I. PERSONAL INFORMATION[/center][/indent][/b][/size][/color][/left][br][/br][/divbox]
[divbox=#303544][br][/br]
[list=none][b]Title:[/b]
[size=85][list=none]
[*][] Mr.
[*][] Ms.
[*][] Mrs.
[*][] Dr.
[*][] Mx.
[*][] Other: [i](state what here)[/i][/list][/size]
[b]Full Name:[/b]
[size=85][i]ANSWER[/i][/size][br][/br]
[b]Date of Birth:[/b]
[size=85][i]DD/MMM/YYYY[/i][/size][br][/br][br][/br]
[b]Gender:[/b]
[size=85][list=none]
[*][] Male
[*][] Female
[*][] Other: [i](state what here)[/i][/list][/size]
[b]Race:[/b]
[size=85][i]ANSWER[/i][/size][br][/br]
[b]Home Address:[/b]
[size=85][i]ANSWER[/i][/size][br][/br]
[b]Phone Number:[/b]
[size=85][i]ANSWER[/i][/size][br][/br]
[b]Email Address:[/b]
[size=85][i]ANSWER (( Include your GTA World forum name here. ))[/i][/size][br][/br][br][/br][/list][br][/br][/divbox][br][/br]
[divbox=#363E54][br][/br][left][color=#47AEBF][size=120][b][indent][center]II. EDUCATION AND TRAINING[/center][/indent][/b][/size][/color][/left][br][/br][/divbox]
[divbox=#303544][br][/br]
[center]If applying for a position other than physician/psychiatrist, only fill out the [b]medical degree[/b] part and delete the rest of the code under this section.[/center]
[list=none][b]Position Applying For:[/b]
[size=85][list=none]
[*][] Physician
[*][] Psychiatrist
[*][] Nurse
[*][] Therapist
[*][] Volunteer[/list][/size][/list]
[hr]
[list=none][b]Medical Degree:[/b]
[list][b]University Name:[/b]
[size=85][i]ANSWER[/i][/size][br][/br][br][/br]
[*][b]Degree Earned:[/b]
[size=85][i]ANSWER[/i][/size][br][/br][br][/br]
[*][b]Graduation Year:[/b]
[size=85][i]ANSWER[/i][/size][br][/br][br][/br]
[*][b]Honors or Distinctions:[/b] [size=70][i](optional)[/i][/size]
[size=85][i]ANSWER[/i][/size][br][/br][/list][/list]
[hr]
[list=none][b]Residency Training:[/b]
[list][b]Residency Program:[/b]
[size=85][i]ANSWER[/i][/size][br][/br][br][/br]
[*][b]Specialty:[/b]
[size=85][i]ANSWER[/i][/size][br][/br][br][/br]
[*][b]Location:[/b]
[size=85][i]ANSWER[/i][/size][br][/br][br][/br]
[*][b]Completion Year:[/b]
[size=85][i]ANSWER[/i][/size][br][/br][br][/br]
[*][b]Honors or Distinctions:[/b] [size=70][i](optional)[/i][/size]
[size=85][i]ANSWER[/i][/size][br][/br][/list][/list]
[hr]
[list=none][b]Fellowship Training:[/b] [size=70][i](if applicable)[/i][/size]
[list][b]Fellowship  Program:[/b]
[size=85][i]ANSWER[/i][/size][br][/br][br][/br]
[*][b]Specialty/Subspecialty:[/b]
[size=85][i]ANSWER[/i][/size][br][/br][br][/br]
[*][b]Institution:[/b]
[size=85][i]ANSWER[/i][/size][br][/br][br][/br]
[*][b]Location:[/b]
[size=85][i]ANSWER[/i][/size][br][/br][br][/br]
[*][b]Completion Year:[/b]
[size=85][i]ANSWER[/i][/size][br][/br][br][/br]
[*][b]Honors or Distinctions:[/b] [size=70][i](optional)[/i][/size]
[size=85][i]ANSWER[/i][/size][br][/br][/list][/list]
[hr]
[list=none][b]Relevant Courses or Certifications:[/b] [size=70][i](optional)[/i][/size][br][/br] 
[quote][i][size=85]List any relevant continuing education courses, workshops, or certifications, including the date completed and issuing organization.[/size][/i][/quote]
[b]Link to Medical License Obtained [url=https://gov.gta.world/viewforum.php?f=900]here[/url]:[/b]
[size=85][i][/size][br][/br][br][/br]
[/divbox][br][/br]
[divbox=#363E54][br][/br][left][color=#47AEBF][size=120][b][indent][center]III. PROFESSIONAL EXPERIENCE[/center][/indent][/b][/size][/color][/left][br][/br][/divbox]
[divbox=#303544][br][/br]
[center]Provide information about your last work experience.[/center]
[list=none][b]Job Title:[/b]
[size=85][i]ANSWER[/i][/size][br][/br]
[b]Employer:[/b]
[size=85][i]ANSWER[/i][/size][br][/br]
[b]Location:[/b]
[size=85][i]ANSWER[/i][/size][br][/br]
[b]Dates of Employment:[/b]
[size=85][i]DD/MMM/YYYY to DD/MMM/YYYY[/i][/size][br][/br]
[b]Responsibilities Summary:[/b]
[size=85][i]ANSWER[/i][/size][br][/br]
[b]Key Accomplishments:[/b] [size=70][i](optional)[/i][/size]
[size=85][i]ANSWER[/i][/size][br][/br][br][/br][/list][br][/br][/divbox][br][/br]
[divbox=#363E54][br][/br][left][color=#47AEBF][size=120][b][indent][center]IV. MOTIVATIONAL LETTER[/center][/indent][/b][/size][/color][/left][br][/br][/divbox]
[divbox=#303544][br][/br]
[list=none][b]Why do you want to work at Valentines Rehabilitation Center?:[/b] [size=70][i](200 words max.)[/i][/size][br][/br] 
[quote][i][size=85]Describe your reasons for wanting to join our rehabilitation center here.[/size][/i][/quote][/divbox][br][/br]
[divbox=#363E54][br][/br][left][color=#47AEBF][size=120][b][indent][center](( V. OUT-OF-CHARACTER INFORMATION )) [/center][/indent][/b][/size][/color][/left][br][/br][/divbox]
[divbox=#303544][br][/br
[b]Discord Username:[/b]
[size=85][i]ANSWER[/i][/size][br][/br]
[b]GTA World Forum Account Name & Link:[/b]
[size=85][i]ANSWER[/i][/size][br][/br]
[b]Unedited Screenshot of UCP Admin Record:[/b]
[size=85][i]ANSWER[/i][/size][br][/br]
[b]Timezone:[/b]
[size=85][i]ANSWER[/i][/size][br][/br]
[b]Provide a screenshot of your character's /stats that you're applying with:[/b]
[size=85][i]ANSWER[/i][/size][br][/br]
[code][/divbox]
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Dr. Aurora Farace, MD, Ph.D
Director
Email: aurora.farace@valentines.rehab
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