Mortimer Hargreaves

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: HARGREAVES, MORTIMER ALFRED

Age: 23
DOB: 02/14/1988
Gender: Male
Address: Hargreaves Funeral Home, 42 Washington Street.
City: Concord
State: NH
Ethnicity: Caucasian
Height: 6'2
Weight: 160lbs
Eye Color: Blue
Hair Color: Dark Brown
Distinguishing Marks: I do not have any tattoos or piercings, though I have a fairly unremarkable scar on the outside of my right forearm from an accident at work.


Medical History:

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

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

If yes, list age of diagnoses by medical professionals, or age of onset below:
Not Applicable

If you are receiving treatment for an ongoing medical complaint, please list prescriptions, strength of dose, frequency of dose, and other treatment plans below:
Not Applicable

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 tobacco, about a half pack a day, and I drink socially. Given that I'm not often as social as I could be, this is quite rare. I am partial to a red wine, but I wouldn't consider it so much 'drinking.'



Green Ridge Residential Registration:

Please list your chosen address within Green Ridge below:
25 Holden Street.

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

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):
None.

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:
No spouse.

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:
Nothing of note. I expect most amenities will be provided for me with the employment position I'm applying for.

Are you a citizen or a permanent (Green Card) resident of the United States of America?:
I am 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?:
I certainly do. Lead Mortician at the town's chapel is the position for which I am applying.

Please list your most recent employment and dates of employment below:
For the past two years I have been working at the funeral home owned by my family. One of those years was my internship, following graduation from my associates degree in funeral service and mortuary science.

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 have been surrounded by the funeral industry since infancy, being as my family has owned and operated Hargreaves Funeral Home in Concord, New Hampshire for many, many years. I am familiar with funeral psychology, directing, mortuary sciences, and just about every other in-and-out of the business.

How do you feel your previous employment will benefit your ability to perform in the position(s) for which you are applying?:
Oh, greatly. This is the work I've been training for since I was little. Not to sound morbid, or melodramatic, but death is my life. I am very dedicated to my work, and I take each case personally, in order to fulfil the needs of each to the best of my ability.



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:
Not applicable

Please provide the name of your previous high school below:
Not applicable

What are your academic strengths?:
Not applicable

What are your academic weaknesses?:
Not applicable

What was your previous Grade Point Average?:
Not applicable

Are you interested in extracurricular activities such as sports, art clubs, maths clubs, etc? If yes, explain below:
Not applicable



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:
AI used to smoke marijuana occasionally. I do not indulge any more. I find my job is enough to entertain my mind these days. I'm much more dedicated and detail oriented than I was in my youth.

Have you ever been convicted of a crime? If yes, please list conviction, age of conviction and circumstances below:
Ah... Regrettably, yes. In my youth I had some problems with maladjustment, you might say. I made some regrettable decisions and actions that I would never make again. When I was a teenager I was accused of attempted murder, of a girlfriend at the time. Conviction was swayed and dropped following my admission to a psychiatric facility. The attempted murder, as they called it, was not so. It was a little too much force in the heat of passion, between consenting partners. Outside of that, I prefer not to go into my personal life. Suffice it to say, after many years of hard work, I am reformed.
((OOC: What he's isn't mentioning are the number of corpses he has 'defiled' both before and since psychiatric screening and treatment, both at a hospital and at Hadley. He is also not mentioning the girl he murdered at Hadley, or the two 'missing persons' in Concord since his release.))

If you answered yes to the above, please list sentences connected to these convictions below:
I was remanded instead to psychiatric care, from which I was discharged at age 18 with a bill of clean health. I was sixteen when I was first admitted for psychiatric care, in Concord.

Have you ever knowingly committed a crime for which you were not convicted or sentenced? If yes, please explain below:
No. ((OOC: Yes!))



Personal Interview:

Why have you chosen to relocate to Green Ridge Island? Please explain below:
While I do love my home town and my family, I'm at the age now that I'd like to branch out on my own, and a position as lead mortician is just what I'm looking for. Your location sounds quite quaint, and the perfect place to get to know people and make friends in the community. It's quite some distance from my home, also, which i think will force me to have to broaden my horizons.

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?:
Certainly.

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:

Mortimer Alfred Hargreaves 05/30/2011

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: Street Address/Apt. Number
Residents at this Address: 25 Holden Street
Employment: Lead Mortician, Green Ridge Chapel
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] HARGREAVES, MORTIMER
[b]Residential Address:[/b] 25 Holden Street
[b]Employment:[/b] Lead Mortician, Green Ridge Chapel
[b]Education:[/b] N/A

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[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.)