Live Scan Request Form

For the safety of our children, we require that all SRVCA volunteers have an SRVCA authorized Live Scan Background Check Clearance to volunteer on campus or chaperone on field trips. Your Live Scan will remain valid as long as your student(s) are enrolled at SRVCA. (Previous Live Scan checks not authorized by SRVCA or CPC are not transferable). Result notifications from the Department of Justice may take up to 3 weeks.

*Please submit one request form per person.

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First Name *
Last Name *
Date of Birth *
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DD
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YYYY
Home Address *
Email Address *
Name of Your Enrolled SRVCA Student(s) *
By submitting this form, I agree to have my FACTS account billed a one time $100 fee.  I understand that my Live Scan will remain valid as long as my student(s) are enrolled at SRVCA. I understand that SRVCA will continue to receive updated information from the DOJ as long as I have clearance. *
Required
Next Steps:
Once you have successfully submitted this form, you will be sent a Live Scan application (by email) that will need to be completed and taken to one of the three UPS store located on the back of the form for fingerprinting.  

After fingerprinting, please bring a signed copy (front and back) of your application to the SRVCA office.

The clearance process may take up to 3 weeks to complete.  Please plan accordingly.

For questions please call the SRVCA office at (925) 838-9622.
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