Los Santos Police Department
PRELIMINARY BACKGROUND APPLICATION – Police Officer
(Rev 03/2022)
PRELIMINARY BACKGROUND APPLICATION – Police Officer
(Rev 03/2022)
Instructions to the Applicant
The information you provide in this Preliminary Background Application will be used in the background investigation to assist in determining your suitability for the position of City of Los Santos Police Officer, in accordance with San Andreas POST Commission Regulation 1953.
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.
BOTTOM LINE: You are responsible for providing complete, accurate, and truthful responses.
Page 1 of 6
The information you provide in this Preliminary Background Application will be used in the background investigation to assist in determining your suitability for the position of City of Los Santos Police Officer, in accordance with San Andreas 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 “DNA” (does not apply) in the space provided.
• Send the completed form to your background investigator or the department. Do NOT send the form to POST.
• (( Your application must be titled "Firstname Lastname. ))
• (( Your answers should only replace the fields that say "Answer." It should not extend outside the color code box. ))
• (( Do not edit the application format in any way. You may add additional fields to any area or questions or replace hyperlinks with DNA. ))
• (( You may be non-select if your application is put on "Pending" status more than twice for formatting issues or missing questions. This is also the case in character. ))
• (( Upon completion of this application, your character will undergo a 'psychological evaluation'. This is entirely an NPC process. It is your responsibility to inform the Personnel and Training Division if your psychological evaluation fails or shows any concerns. ))
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.
BOTTOM LINE: You are responsible for providing complete, accurate, and truthful responses.
Page 1 of 6
SECTION 1: PERSONAL
1. Your Full Name:
Page 2 of 6
- Last: Coopra
First: Sam
Middle: DNA
- 17/AUG/1998
- Los Santos, Los Santos County, San Andreas, United States of America
- [X] Male
[—] Female
- [—] Black
[—] Hispanic
[—] Asian
[X] Caucasian
[—] Pacific Islander
[—] American Indian or Alaskan Native
[—] Filipino
[—] Two or more races
- 5 ft 8 in
- 155 lbs
- Ginger Street, Little Seoul, City of Los Santos, San Andreas
- 3048048
- [X] Yes
[—] No
- 10.1. If NO, are you a resident alien who is eligible and has applied for U.S. citizenship?
- [—] Yes
[—] No
[X] This does not apply to me
- [—] Yes
- 10.1. If NO, are you a resident alien who is eligible and has applied for U.S. citizenship?
- Spanish (basic)
Page 2 of 6
SECTION 2: EDUCATION, EXPERIENCE, AND EMPLOYMENT
- • List ALL jobs you have had, including part-time, temporary, self-employment, and volunteer. (Begin with your most current.)
• If you have military experience, including reserve duty, enter your military base, assignments, or unit of assignment.
12. List all high schools, colleges, and universities attended:
Page 3 of 6
- Name of School: Vespucci High School
Enrollment Term: 08/MAR/2014 to 11/APR/2017
Location: Los Santos, Los Santos County, San Andreas, United States of America
Type of Degree Earned: High School Diploma
Major/Area of Study: DNA
- Name of Employer: DeLuca's Pizza
Employment Term: 15/AUG/2022 to 22/SEPT/2023
Job Title/Rank: Food Delivery Driver
Duties/Assignments: Ensure the order is correct and make the delivery to customers.
- [—] Army
[—] Navy
[—] Air Force
[—] Marines
[—] Coast Guard
[—] National Guard/Reserves
[X] This does not apply to me
Page 3 of 6
SECTION 3: MOTOR VEHICLE INFORMATION
15. Do you have a valid San Andreas driver's license?
Page 4 of 6
- [X] Yes
[—] No
- [—] Yes
[X] No
- 16.1. If YES, explain (include when, where, and circumstances):
- DNA
- 16.1. If YES, explain (include when, where, and circumstances):
- [—] Yes
[X] No
Page 4 of 6
SECTION 4: LEGAL
- • This section requires you to report detentions, arrests, and convictions, As a peace officer applicant, you are required to disclose this information unless specifically exempted by state or federal law.
• For the purpose of responding to Question 20, “illegal drugs” include the unauthorized or illegal use of prescription medications or over-the-counter drugs; it also includes the illegal use of any other substance for the purpose of getting “high".
• For the purpose of Question 22, consider "under the influence" as when you may have been arrested if stopped by the police.
18. Have you ever been detained by law enforcement for investigation, arrested, indicted, charged, or convicted of any misdemeanor or felony offense in this state or any other legal jurisdiction?
Page 5 of 6
- [—] Yes
[X] No
- 18.1. If YES, explain each incident:
- DNA
- 18.1. If YES, explain each incident:
- [—] Yes
[X] No
- [—] Yes
[X] No
- 20.1. If YES, give details including drug(s) used, most recent date, and circumstances:
- DNA
- 20.1. If YES, give details including drug(s) used, most recent date, and circumstances:
- [X] Never
[—] Within the last 6 months
[—] Within the last 12 months
[—] More than 12 months ago
- [—] Yes
[X] No
Page 5 of 6
SECTION 5: CERTIFICATION
23. I hereby certify that I have personally completed and initialed each page of this form and any attached supplemental page(s), and that all statements made are true and complete to the best of my knowledge and belief. I understand that any misstatement of material fact may subject me to disqualification; or, if I have been appointed, may disqualify me from continued employment.
Sam Coopra
Page 6 of 6
Sam Coopra
Date: 06/12/2023
Page 6 of 6
(( SECTION 6: OUT OF CHARACTER ))
- • Do not edit or crop your admin record screenshots in Question 29. The only exception to this is blacking/blurring out your IP address.
• Prior to filling out Question 34, please ensure that your character background story meets the criteria stated in (( NOTICE — Character Development and Expectations )).
24. Timezone (GMT):
- UTC+7
- Gary Manning
- Sam Coopra
- [—] Yes
[X] No
- 30.1. If YES, provide a link to your most recent reinstatement request:
- DNA
- DNA
- 30.1. If YES, provide a link to your most recent reinstatement request:
- [—] Yes
[X] No
- 31.1. If YES, provide a link to your double faction approval:
- DNA
- 31.1. If YES, provide a link to your double faction approval:
- [X] Yes
[—] No
- Spoiler: show
