JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
LiveScan Background Screening Form
Spirit of Giving provides Level II LiveScan Background Screening. We take your fingerprints digitally and submit them to the Florida Department of Law Enforcement and FBI for processing.
** We DO NOT see your results.**
Your results will be sent to the agency that requested them.
**We DO NOT provide fingerprint cards with ink** .
We cannot do background screening for the Department of Agriculture/Concealed Weapon License.
Our price varies from $65- $85.The price is contingent on the ORI number you provide. Please call to confirm the price of your fingerprints. Payment is due prior to Service (Unless we bill the agency or nonprofit)
The information below is required by the Florida Department of Law Enforcement and FBI.
Please call our office for further directions. 561-385-0144
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Please Check All that Apply
*
I have made an appointment for fingerprinting
I have pre paid for my appointment
I will pay at the time of my appointment
The agency/nonprofit requesting is paying for my finger printing
Required
Date of Appointment
*
MM
/
DD
/
YYYY
ORI or VECHS Number
*
Number provided by the agency that sent you to get fingerprinted. This number is required to be fingerprinted. It is a 9 digit number.
Your answer
OCA Number
**this is not required** Your agency should provide this number if you need to use this.
Your answer
Referring Agency (Who sent you to get fingerprinted?)
*
Your answer
Full Name
*
Please include First Name, Middle Name and Last Name
Your answer
Birth Date
*
MM
/
DD
/
YYYY
Phone Number
*
Your answer
Current Address (full address).
*
Must Include Street Address, City, State, Zip Code (Please input you complete address)
Your answer
Sex
*
Choose
Male
Female
Height
*
Your answer
Weight
*
Your answer
Eye Color
*
Your answer
Hair Color
*
Your answer
Place of Birth
*
State and Country
Your answer
Country of Citizenship
*
Your answer
Race
*
American Indian or Alaska Native
Asian or Pacific Islander
Black
Hispanic or Latino
White
Other
Please select one of the options below:
*
I will have my Social Security Number ready.
I do not have a social security number but I will provide an alternative (State ID, Misc.ID, etc.)
Required
Read to confirm by checking the box
*
The information that I have provided above is correct and I understand this will be submitted to the Florida Department of Law Enforcement.
Payment is due prior to fingerprinting. (Unless we bill the referring agency) Payment Link
https://spiritofgivingnetwork.com/background-screening-payment/
Required
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Spirit of Giving Network.
Report Abuse
Forms
