Level 2 Live Scan Validation Form

DUE TO THE CURRENT PUBLIC HEALTH CRISIS MASK REQUIRED FOR ENTRY!

NO ENTRY FOR CUSTOMERS WITH ANY OF THE FOLLOWING SYMPTOMS:

COUGH, SNEEZE, SORE THROAT, RUNNY NOSE, FEVER, ANY COLD/FLU TYPE SYMPTOMS

 

This form is required to be submitted by all applicants prior to their appointment.  We have eliminated the paper application at the office to reduce contact between applicants and staff.  If you have any questions,  give your local office a call.

 

Step 1 of 2

Name of Person Being Screened:(Required)
Person Being Screened Home Address(Required)
MM slash DD slash YYYY
Gender(Required)
Enter your current hair color
RACE:(Required)
This Field is an FBI / FDLE Required Entry.
This number is required and is usually assigned by your state licensing agency or employer. If you do not use the correct ORI, your screening will go to the wrong agency, and you will be required to pay for a second screening.
You have been asked by someone to have a Level 2 screening performed. In most cases, your employer will be entered here. If self employed enter self.
Screening Appointment Location