ATI # SUBMISSION: Proof of Completed Live Scan for UCCE Volunteers
We do not need a copy of your Live Scan form. The limited information you provide below is used to check your volunteer clearance status and expedite the volunteer approval process. If you have any questions, please call the 530-621-5502.
Sign in to Google to save your progress. Learn more
Applicant Legal LAST Name *
Applicant Legal FIRST Name *
Applicant Middle Name/Initial
Applicant Date of Birth *
MM
/
DD
/
YYYY
I am applying to volunteer with the following program: *
I am applying to volunteer in the following county: *
Date Live Scan Completed *
MM
/
DD
/
YYYY
Name of agency/business where Live Scan was done: *
City where Live Scan was done: *
ATI # (located at the bottom of your Live Scan form): *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of UC Davis. Report Abuse
Google Forms