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PERSONAL DATA
1. LAST NAME, FIRST NAME (AND ALIAS OR CODE NAME IF APPLICABLE)
2. PROFESSION (RANK IF APPLICABLE)
3. EMPLOYER
4. NATIONALITY
5. SEX F
6. AGE AND D.O.B. M
7. EDUCATION AND OCCUPATIONAL HISTORY
8. STATISTICS
SCORE
×5
11.
DISTINGUISHING FEATURES
BONDS
SCORE
Strength (STR) Constitution (CON)
STATISTICAL DATA
Intelligence (INT) Power (POW) Charisma (CHA)
9.
DERIVED ATTRIBUTES
MAXIMUM
CURRENT
Hit Points (HP)
PSYCHOLOGICAL DATA
Dexterity (DEX)
12.
MOTIVATIONS AND MENTAL DISORDERS
Willpower Points (WP) Sanity Points (SAN) Breaking Point (BP)
10. PHYSICAL DESCRIPTION 13. INCIDENTS OF SAN LOSS WITHOUT GOING INSANE
Accounting (10%)
First Aid (10%)
Ride (10%)
Alertness (20%)
Forensics (0%)
Science (0%):
Anthropology (0%)
Heavy Machinery (10%)
Archeology (0%)
Heavy Weapons (0%)
Search (20%)
Art (0%):
History (10%)
SIGINT (0%)
HUMINT (10%)
Stealth (10%)
Artillery (0%)
Law (0%)
Surgery (0%)
Athletics (30%)
Medicine (0%)
Survival (10%)
Bureaucracy (10%)
Melee Weapons (30%)
Swim (20%)
Computer Science (0%)
Military Science (0%):
Unarmed Combat (40%)
Craft (0%):
Unnatural (0%)
Navigate (10%)
Foreign Languages and Other Skills:
Criminology (10%)
Occult (10%)
Demolitions (0%)
Persuade (20%)
Disguise (10%)
Pharmacy (0%)
Dodge (30%)
Pilot (0%):
Drive (20%)
Firearms (20%)
Psychotherapy (10%)
Check a box when you attempt to use a skill and fail. After the session, add 1 to each checked skill and erase all checks.
THIS IS A WORK OF FICTION
APPLICABLE SKILL SETS
Violence adapted Helplessness adapted
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. 16.
WEAPONS
SKILL %
BASE RANGE
DAMAGE
ARMOR PIERCING
LETHALITY %
KILL RADIUS
AMMO
(a) (b) (c) (d) (e) (f) (g) 18. DEVELOPMENTS WHICH AFFECT HOME AND FAMILY
19.
SPECIAL TRAINING
SKILL OR STAT USED
THIS IS A WORK OF FICTION
REMARKS
17. PERSONAL DETAILS AND NOTES
Please indicate why this agent was recruited and why the agent agreed to be recruited. 20. AUTHORIZING OFFICER
DD
UNITED STATES FORM
315
21. AGENT SIGNATURE
TOP SECRET//ORCON//SPECIAL ACCESS REQUIRED-DELTA GREEN AGENT DOCUMENTATION SHEET
