Kohaku Honda

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: Honda, Kohaku

Age: 25
DOB: 03/18/1986
Gender: Male
Address: 32 East 3rd Street
City: New York
State: New York
Ethnicity: Japanese
Height: 5’9 ft.
Weight: 145 lbs.
Eye Color: Brown
Hair Color: Black
Distinguishing Marks: The Japanese proverb, “Knock on the sky and listen to the sound” is written in kanji (Real kanji, not sketchy-drunken-tattoo-parlor kanji) in black lettering down my spine.


Medical History:

Please list any and all allergies and age of onset below:
I found out that I was lactose intolerant when I was fourteen. The hard way.

Are you aware of any ongoing medical issues?:
I have Bipolar Disorder Type I, predominately manic. I only get depressed on occasion.

If yes, list age of diagnoses by medical professionals, or age of onset below:
I was diagnosed with Manic Depression at age 12, but before, they thought I had ADHD and gave me stimulants. You can imagine how that went. I guess it’s hard to tell whether your hyperactive kid who has trouble paying attention has ADHD or Bipolar- trial and error was their policy apparently.

If you are receiving treatment for an ongoing medical complaint, please list prescriptions, strength of dose, frequency of dose, and other treatment plans below:
I take 300 mg of Lithium once in the morning and once in the evening, totaling to 600 mg per day. It keeps me in line somewhat.

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 was a recreational smoker and drinker in late high school and early community college. I only really did that stuff at parties- I straightened out once I realized I couldn’t mess around anymore. Thankfully, I never got addicted to either. I’ve tried weed once in early adulthood and hated it. Although, I do drink occasionally when I’m the mood for it. I’m a lightweight so I don’t drink much at one time, not to mention I’m careful that I don’t take my meds beforehand, and I’m responsible with it. No more than two beers at one time and no sign that I even touched alcohol in front of the students.

Please list any known ongoing medical issues of any dependents below. Please note to which dependent each issue belongs:
N/A



Green Ridge Residential Registration:

Please list your chosen address within Green Ridge below:
26 Beach St. Apt #121

Please list any dependents who reside with you. Please include ages and relationship to yourself:
N/A

Please list your marital status. Single/Married/Divorced/Widowed. If married, please list name of spouse and note if he/she intends to reside with you at this address:
Ridin’ solo! Single.

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:
Well, since it’s a small island, I just brought my bike. I never had a car when I lived in the city, either. I have a Macbook laptop, a Yamaha keyboard and a small printer, but don’t tell the burglars.

Are you a citizen or a permanent (Green Card) resident of the United States of America?:
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 am applying for the World History teaching position at Drayton Academy.

Do you possess necessary qualifications for the position(s) for which you are applying? If yes, please list official qualifications below:
High School- Mahopac High School (2004)
Community College- Dutchess Community College. Associates in Adolescent History Education. (2006)
University- State University of New York at New Paltz. Bachelor’s of Education in Adolescent History Education. (2008)
Graduate School- Teacher’s College at Columbia University. Master’s of Education in History. (2010)

Besides holding the necessary degrees, I have experience in the classroom through interning at Stuyvesant High School in New York City.

Please list your three most recent employment positions and locations of employment below:
Advanced Placement World History intern- Stuyvesant High School. (September 2010-June 2011) I taught mostly sophomores.
Freelance tutoring- (September 2006-June 2011) I tutored as many three kids per school year while also attending community college and university, as well as when I interned. Individual sessions were one to two hours long. All of them were high school students.
McDonald’s- (July 2004-June 2006) Don’t judge.

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:
Through personality, I’m very charismatic and have the ability to make even the most mundane parts of history easy to understand and enjoyable to learn about, which comes in handy in the classroom. It’s probably my energy. It never ends! I haven’t had anyone fall asleep while teaching history yet, and will strive to continue that record. I am also fluent in American Sign Language.

How do you feel your previous employment will benefit your ability to perform in the position(s) for which you are applying?:
Although I was only an intern at Stuyvesant High School, a full year there was exactly like teaching. I have experience, through interning and tutoring, with teaching history both in a group setting and one-on-one. To be honest, I was offered a position at Stuyvesant for the 2011-2012 school year, but I declined because teaching there was too easy. The true reason why I am applying to Drayton Academy in particular is because the student body consists of both students with mental issues and those without. It’s exciting just to think about helping the patients of St. Christina’s Psychiatric Rehabilitation Center- they probably don’t have many adults who they wouldn’t want to fight against. I’m a relatable person, particularly to high school-aged students, and I know how to handle them well.



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:
Nope. I’m a good boy!

Have you ever been convicted of a crime? If yes, please list conviction, age of conviction and circumstances below:
Disturbing the Peace- Age 15 (I pitched a tent in the middle of Starbucks. It seemed like a good idea at the time.)
Disorderly conduct- Age 15 (I went into a Rite Aid bathroom, wrapped my whole body in paper towel and ran around the store screaming- kids ran away because they thought I was a resurrected mummy.)
Trespassing- Age 16 (A group of friends and I made a snow fort that greatly resembled the Hoth station in Star Wars… at 1 am… in someone else’s yard. What can I say? They had a lot of snow.)

If you answered yes to the above, please list sentences connected to these convictions below:
Community service- they were actually kind of nice about it. The cops didn’t give me too many hours because they always laughed whenever they caught me doing something stupid. I was their entertainment for the night.

Have you ever knowingly committed a crime for which you were not convicted or sentenced? If yes, please explain below:
In my freshman year of high school, I bought boxes upon boxes of magnum condoms, blew them all up and left them all in the faculty lounge to await many faint-hearted teachers’ screams. I never got caught, but I swear I will throw a parade to the student who does that to me.



Personal Interview:

Why have you chosen to relocate to Green Ridge Island? Please explain below:
Like I said before, if hired, I’d be really excited to work with kids who have mental issues- I’ll be able to relate to them better. Oh, that and Green Ridge is an island- I love beaches and major change. So this is perfect.

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! None of us are normal- the ones who say they are more insane than those who've already accepted it.

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

Finally, please tell us a little about yourself. Where did you grow up, and what was it like? What were your prior relationships with significant others/family or friends like? What instances have lead to your current choice in career and/or relocation? What events in your life do you feel have shaped who you are today? Include any information you feel that is pertinent about yourself and your situations:
I grew up in a small town called Mahopac in upstate New York. Nothing really happened there- the most exciting thing about it was Lake Mahopac, a big lake that you can water-ski on, and you can only buy a house near the water if you’re filthy rich.

I have a twin brother (We’re fraternal) named Yuuto who is, literally, the polar opposite of me. He was the good kid who never got in trouble, and he still can’t seem to take a joke. He’s bashful while I never get embarrassed. Yuu-chan (He hates when I call him that) and I were always really close- we shared a room willingly until we both moved out. I think the reason for this is because we balance each other out like yin and yang. We’re both bipolar; Yuu struggles to get out of bed most days because of his depression and I’m always bouncing off the walls because of mania. Our parents were always running around trying to catch up with our shifts in mood. They’re good people- they both immigrated from Japan and raised us without forcing intense piano lessons down our throats or something. (Although, I picked up piano later in my adolescence and I love it. But I probably wouldn’t love it if I were forced into it.)

The reason why I became a history teacher is, literally, because I didn’t want to go through the schooling to be a doctor. History was always my best subject and I ran with it. Yuuto went on to become a social worker when he graduated from college. One of the only things in common we have with one another is that we both love to help people. That’s the main reason why I applied for a position on your island- I want to do my part to make a difference in the lives of kids who aren’t as fortunate as me to have a mental disorder and not get hospitalized for a lengthy period of time. They probably don’t have too many adults who they respect or can connect with.

Because of my mania, all my life I thought I could do anything. I remember when my brother and I were kids, I wanted to jump off the roof because I thought I could fly- Yuuto had to tackle me to make sure that didn’t happen. I’m always euphoric and it clouds my vision, and I didn’t realize the full extent of having too much fun until I spiraled into psychosis. Leading up to my episode, I wasn’t sleeping more than usual, I was doing and thinking stupid things and I was exercising like a gerbil. When I was sixteen, I started to see a black dog appear in and out of the walls in my math classroom. I screamed and freaked out and babbled incessant gibberish until I had to be hospitalized. It was the scariest thing in the world.

That incident alone made me realize how inattentive I was to my own issues- I vowed from that day on that I’d take my meds and be extra sure that I won’t get out of control with my excessive happiness. Most of the stupid stuff I do is because I don’t think about it beforehand. I don’t think about it because I’m too energetic and excited about life to do so. Sometimes, I have to force myself to calm down by breathing, but I usually don’t want to. Mania is a tricky thing; you’re having so much fun that you don’t see how many people you hurt.


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 dependents 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:

Kohaku Honda 06/10/2011

Sorry about that! Edited.

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: 26 Beach Rd. Apt. 121
Residents at this Address: Kohaku Honda
Employment: History Teacher, Drayton Academy
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:

[center][font=garamond][size=22][color=#555555][b] -File Note- [/b][/color][/size][/font]

_____________________________________________________________[/center]

[b]Resident Name:[/b] Honda, Kohaku
[b]Residential Address:[/b] 26 Beach Rd. Apt. 121
[b]Employment:[/b] History Teacher, Drayton Academy
[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.)