Eclipse Government

Personal information
Name: Dyalen Shroder

Phone number: 4129882

Occupation: applying for jobs now

Have you ever been convicted of a crime?: no

Have you recently been convicted of a felony crime?: no

Request details
When are you available?:
till 4pm pacific time

Why do you wish to go on a ride-along with the Los Santos Emergency Medical Department?:
so i can apply and see if i like it

((Timezone relative to UTC)): UTC- 7

By signing this form, you agree to the following terms and conditions:

• I will not interfere with the EMT doing their job.
• I agree to the LSEMS conducting background checks to determine my suitability for a ride along
• I will listen to the EMT's instructions at all times, unless it is to assist in their work.
• The EMT can stop the ride-along at any point at their own discretion.
• I will not bring any weapons.
• If I get injured, the LSEMS can not be held responsible, unless gross misconduct led to the injuries.
• While on scenes with police involved I will remain in the ambulance and will not communicate with anyone.
• I will show I possess common sense.

Signature: Dyalen Shroder
Date Signed: 7/16/2019/font]

Dear Mr. Shroder,

Your ride-along request with the Los Santos Emergency Medical Services has been DENIED. We would like to thank you for showing interest within our ride-along program, however it has been denied due to the following reasons.

• Charge of assault and attempted assault on a government official on the 28th of June. Feel free to reapply when enough time has passed. ((1 month OOC without a charge.))

Sincerely,

Jace Bianch
Sr. Paramedic and Fire Coordinator
Los Santos Emergency Medical Services