Lux Ayers

Please use blue or black ink when filling out this registration form. Please answer all questions to the best of your ability. For further information or guidance, please contact a member of the Green Ridge town administration team at the number provided in our guide brochure.

Full Name: AYERS, LUX

Age: 41
DOB: 07/13/1969
Gender: Female
Address: 3 Warren St. Apt. 7
City: Salem
State: Massachusetts
Ethnicity: Caucasian
Height: 5ft 7in
Weight: 133 lbs.
Eye Color: Brown
Hair Color: Brown
Distinguishing Marks: I have a pentacle tattoo on my left inner wrist and a triple moon on my right inner wrist.


Medical History:

Please list any and all allergies and age of onset below:
No known allergies.

Are you aware of any ongoing medical issues?:
No known medical issues.

Please list any known ongoing medical issues of any dependents under the age of thirteen below. Please note to which dependent each issue belongs:
No dependents.

If yes, list age of diagnoses by medical professionals, or age of onset below:
N/A

If you are receiving treatment for an ongoing medical complaint, please list prescriptions, strength of dose, frequency of dose, and other treatment plans below:
N/A

Do you smoke tobacco, consume alcohol, or use street drugs? If yes, please list number of packs per day, number of drinks per day and/or names of consumed drugs below:
I smoke shisha from a hookah every so often, usually before and after rituals. I drink socially and will have a single glass of red wine with my dinner every night. I will smoke marijuana every now and again, especially if my day has been extremely stressful. (You have no idea how stressful it can be to divine into someone's future and give them accurate information without changing the course of that future but as they say, the Goddess works in mysterious ways.)



Green Ridge Residential Registration:

Please list your chosen address within Green Ridge below:
33 Sunset Boulevard

Please list any dependents under the age of thirteen, who reside with you:
No dependents.

Please list any dependents over the age of thirteen who reside with you (Be advised that dependents over the age of thirteen must also complete a registration form):
No dependents.

Please list any other residents at this address who are not dependents:
No other residents.

Please list your marital status. Single/Married/Divorced/Widowed:
Single.

If married, please provide the name of your spouse if he/she resides with you:
N/A

Please list any large taxable material possessions below, such as motor vehicles or other property of substantial value that will be relocating to Green Ridge Island with you:
I'll be bringing my 1937 Black Studebaker Hearse. It's my prized possession. Inherited from my Grandfather. He owned a funeral home until the day he died.

Are you a citizen or a permanent (Green Card) resident of the United States of America?:
I'm a citizen.



Employment Registration (Optional):

This section is for those of age sixteen or older who plan to find employment on Green Ridge Island. If you do not meet the criteria, please move to the next section.

Do you plan to find employment on Green Ridge Island? If so, which position(s) are you applying for, and where?:
Yes. I'd like to move my business to the island. I've an idea in mind of a New Age Metaphysical Shop by the name of The Broom Closet.

Please list your most recent employment and dates of employment below:
Most recently, I had been working at a shop called the Crystal Candle. I had been doing palm readings, tarot readings, scrying, spell crafting and other services for folks. Been there from 2000 until the present when my business partner grew a little clingy. When someone loves you and you don't feel the same, it's time to move on. Before that, I helped prepare the dead for viewing while working at my Grandfather's funeral home. I worked for him from the age of 14 until he passed away in 2000.

Do you possess any other skills that you feel may benefit your ability to perform in the position(s) for which you are applying? Examples include extra languages, history of customer service and work in the care industries, etc. If yes, please list skills below:
I speak sign language, I have also been a practicing Eclectic Page since I was 14 years old. This has allowed me to come into contact with many types of people from many different walks of life. I have read the palms of dignitaries and homeless alike. I believe that I am fully qualified to own a business that helps fulfill the spiritual needs of the souls that wish for it.

How do you feel your previous employment will benefit your ability to perform in the position(s) for which you are applying?:
I believe that I have fully answered this question in many of my other responses but I wish to expand upon them by stating that the Goddess blessed me with the ability to connect with people and this ability has been fully trained through my previous employments.



Education Registration (Optional):

This section is for Green Ridge Island residents under the age of eighteen. All resident under the age of eighteen who do not possess a high school diploma, GED, or reside at St. Christina's Psychiatric Rehabilitation Center are required to complete this education registration. Those who do not meet these criteria, please disregard this section and move to the next.

Please list your high school grade. Freshman/Sophomore/Junior/Senior:
N/A

Please provide the name of your previous high school below:
N/A

What are your academic strengths?:
N/A

What are your academic weaknesses?:
N/A

What was your previous Grade Point Average?:
N/A

Are you interested in extracurricular activities such as sports, art clubs, maths clubs, etc? If yes, explain below:
N/A



Legal History:

Be advised that answers to this section will not affect your eligibility for relocation to Green Ridge. The information you provide will not be diverged to third parties.

Do/did you ever abuse controlled substances, including but not limited to prescription medications, street drugs or alcohol? If yes, please explain below:
Yes. As stated previously, I smoke marijuana but I do not abuse drugs. My body is a temple and I treat it as such.

Have you ever been convicted of a crime? If yes, please list conviction, age of conviction and circumstances below:
N/A

If you answered yes to the above, please list sentences connected to these convictions below:
N/A

Have you ever knowingly committed a crime for which you were not convicted or sentenced? If yes, please explain below:
Well, of course. We all do something. Jay-walking is illegal for Gods sakes! But, seriously, I've smoked illegal substances. No matter that it comes from the Goddess... Some people just don't understand the good that the 'weed' could do for the world.



Personal Interview:

Why have you chosen to relocate to Green Ridge Island? Please explain below:
If I told you that my cards insisted for over a year that I needed a change, you would think I'm insane. So I will give you a more mundane answer. The man that I was seeing became a little clingy and I have always wanted to live on the West Coast. Can't get much more West from Salem than Green Ridge. Besides, the island seems like a wonderful slice of nature. I'd like to experience it.

Green Ridge Island houses a psychiatric rehabilitation hospital, and as such, living and working amongst those with mental health issues would be typical practice. Are you comfortable with this?:
Of course. All souls need help from time to time. One of the things that drew me toward opening my business on this slice of 'heaven' was that its entire purpose is to assist other human beings.

Do you agree to abide by all Green Ridge Island laws and regulations upon relocation?:
Yes.


Resident Signature:

By opting to relocate to Green Ridge Island and the town of Green Ridge, you hereby agree to abide by all Green Ridge Island laws and the instructions of Green Ridge Security, Green Ridge Town Officials, and St. Christina Facility administrators. You hereby waive rights granted to you by the state of Oregon or any other state belonging to the United States of America or to any other country or county. You acknowledge that Green Ridge Island, the town of Green Ridge and the St. Christina facilities are not subject to any state laws. You acknowledge that any personal property transported to Green Ridge Island becomes the responsibility of GR Biotech and its subsidiaries. You hereby waive your right to register to vote in any states within the continental United States, within the states of Alaska and Hawaii, and within any US territories. You waive your right to representation by any political parties or persons within the aforementioned US locations or other countries. You acknowledge that you are legally bound not to disclose information regarding Green Ridge laws, protocols or procedures of any kind with persons not residing on Green Ridge Island. You acknowledge that visitors to Green Ridge Island become the sole responsibility of the undersigned, and are subject to the same laws, protocols and procedures as Green Ridge island residents during their stay. You acknowledge that visitors to Green Ridge Island are subject to surveillance by Green Ridge officials and employees, and may be removed from the island without notice. You acknowledge that any minors under the age of thirteen (13) that are claimed as dependants remain the sole responsibility of the undersigned, and are subject to the same laws, protocols and procedures as all Green Ridge Island residents. GR Biotech and its Subsidiaries reserve the right to add to or amend these terms of service at any time.

Please sign and date below:

Lux Ayers 05/29/2011

Welcome to Green Ridge. Below you'll find your pertinent residential, employment and scholastic information. Please take this time to familiarise yourself with the island layout and requisite handbooks, rules and regulations. Thank you for joining our community.

Residential Address: 33 Sunset Boulevard
Residents at this Address: Lux Ayers
Employment: The Broom Closet Owner
Education: N/A


Final Application Approval Steps for Players:


Before you can begin play on STC, you must complete these final steps:

• Sign up your playby on the faceclaim.
  
• Sign up for the who plays who list.
  
• Sign up for your assigned membergroup (shown above) HERE (Pay close attention to pick the correct usergroup listed on this approval stamp! Characters that are not signed up for their correct membergroups after approval will be subject to deletion during the next activity check.)
  
• Familiarise Yourself with your Staff & Resident Handbooks, located in the St. Christina's Rosters and Information, and Green Ridge Rosters & Information forums, on the main board.

Code:

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[b]Resident Name:[/b] Ayers, Lux
[b]Residential Address:[/b] 33 Sunset Boulevard
[b]Employment:[/b] The Broom Closet Owner
[b]Education:[/b] N/A

[center]_____________________________________________________________[/center]

[b]Note Subject:[/b] (Behavioural Report, Progress Report, Procedure Report, Disciplinary Report, etc.)

[b]Note Contents:[/b] (Explain behaviour observations, procedures, disciplinary actions, medical reports, etc. here)

[b]Note Author:[/b] (Your character name here.)

[b]Other:[/b] (Optional extra notes here.)