Livescan Pre-Registration Application

LIVESCAN PRE-REGISTRATION APPLICATION

First Name *

Middle Initial

Last Name *

Date of Birth *

Gender *

Male

Female

Height *

Example 5 Foot 6 Inches

Weight *

Weight in pounds.

Eye Color *

Hair Color *

Race *

Black

White

Asian/Pacific Islander

Native American

Other

Place of Birth *

Citizenship

Address *

City

State/Province

Zip/Postal

Daytime Phone *

Evening Phone *

Application Type? *

Agency Authorization #

ORI # (If Required)

Reason Fingerprinted?

Agency Authorization #

ORI # (If Required)

Reason Fingerprinted?

Agency Authorization #

ORI # (If Required)

Reason Fingerprinted?