REINSTATEMENT REQUEST FORM — POLICE OFFICER
(Rev 12/2024)
SECTION 1: PERSONAL
- 1. YOUR FULL NAME:
- Last: Collins
First: Dominique
Middle: D.N.A.
- Last: Collins
SECTION 2: DEPARTMENT HISTORY
- 2. DEPARTMENT HISTORY:
- Position: Commanding Officer, In-Service Training Group
Date of resignation/termination: 11/JAN/2025
Resignation/termination record: No Access
- Position: Commanding Officer, In-Service Training Group
SECTION 3: STATE AGENCY POSITIONS
- NOTE: If you have been employed by another state agency during your length of absence, you are required to fill the fields below.
- 3. LIST AGENCIES:
- Name of agency: D.N.A.
Position: D.N.A.
Date of resignation/termination: DD/MMM/YYYY
Name of agency: D.N.A.
Position: D.N.A.
Date of resignation/termination: DD/MMM/YYYY
- Name of agency: D.N.A.
SECTION 4: OUT OF CHARACTER
- The information in this section is Out of Character information only.
Your admin record may only be edited to blackout/blur your IP Address.
- 4. OUT OF CHARACTER INFORMATION:
- Link to your LS-RP forum account: Access
List all current and past character names, on every account, and their levels:
plhdrCole Harlow - Level 9
plhdrDrake Hollow / Dominique Collins - Level 20
plhdrRobert West / Luke Henderson / Yo Kuncoi - Level 6
Link an unedited screenshot of your admin record for all your characters on every account:Spoiler: show
Why did you previously leave the faction?: This was discussed with the Staff Officers involved in the situation. I was asked to help another faction.
If you are currently in another official faction, what is the name of the faction?: No.
If yes, provide the link to your double faction approval from the LSPD: Access.
Are you currently banned from any other legal factions? If so, provide their name(s): No.
Are you attempting to reinstate under a different name? If so, what name?: Eduardo Lopez
Desired rank and assignment? (Only if applicable.) D.N.A.; Up to you.
- Link to your LS-RP forum account: Access