PERSONAL DATA
1. LAST NAME, FIRST NAME, MIDDLE INITIAL
2. PROFESSION (RANK IF APPLICABLE)
3. EMPLOYER
4. NATIONALITY
5. SEX
M
F
6. AGE AND D.O.B.
7. EDUCATION AND OCCUPATIONAL HISTORY
STATISTICAL DATA
10. PHYSICAL DESCRIPTION
PSYCHOLOGICAL DATA
12. MOTIVATIONS AND MENTAL DISORDERS
13. INCIDENTS OF SAN LOSS WITHOUT GOING INSANE
Violence
adaptedHelplessness
adaptedAPPLICABLE SKILL SETS
Accounting (10%)
Alertness (20%)
Anthropology (0%)
Archeology (0%)
Art (0%)
Artillery (0%)
Athletics (30%)
Bureaucracy (10%)
Computer Science (0%)
Craft (0%)
Criminology (10%)
Demolitions (0%)
Disguise (10%)
Dodge (30%)
Drive (20%)
Firearms (20%)
First Aid (10%)
Forensics (0%)
Heavy Machinery (10%)
Heavy Weapons (0%)
History (10%)
HUMINT (10%)
Law (0%)
Medicine (0%)
Melee Weapons (30%)
Military Science (0%)
Navigate (10%)
Occult (10%)
Persuade (20%)
Pharmacy (0%)
Pilot (0%)
Psychotherapy (10%)
Ride (10%)
Science (0%)
Search (20%)
SIGINT (0%)
Stealth (10%)
Surgery (0%)
Survival (10%)
Swim (20%)
Unarmed Combat (40%)
Unnatural (0%)
Check a box when you attempt to use a skill and fail. After the session, add 1D4 to each checked skill and erase all checks.
INJURIES
14. WOUNDS AND AILMENTS
Has First Aid been attempted since the last injury?
Yes: Only Medicine, Surgery, or long-term rest can help further.
EQUIPMENT
15. ARMOR AND GEAR
Body armor reduces the damage of all attacks except Called Shots and successful Lethality rolls.
REMARKS
17. PERSONAL DETAILS AND NOTES
18. DEVELOPMENTS WHICH AFFECT HOME AND FAMILY
Please indicate why this agent was recruited and why the agent agreed to be recruited.
DD
UNITED STATES
FORM
315
TOP SECRET//ORCON//SPECIAL ACCESS REQUIRED—DELTA GREEN AGENT DOCUMENTATION SHEET
112382
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