LCA Fingerprints, LLC - Company Enrollment Form

Company Name *

Company Address *

Contact First Name *

Contact Last Name *

Company Contact Email *

Company Contact Phone *

Background Check Type *

BCI

FBI

BCI and FBI

Select Payment Method *

Credit Card

Invoice

Direct Copy Options (Select Only One) *

Ohio Construction Board

Ohio Dept of Education

Ohio Dept of Liquor Control

Ohio Lottery Commission

Ohio Racing Commission

BMV Dealer Licensing

BMV Deputy Registrar

Ohio Board of Nursing

Ohio Medical Board

Social Worker Board

Ohio Board of Pharmacy

Child Care Center/Type A-ODJFS

Ohio Veterinary Medical Licensing Board

State Speech & Hearing Professionals Board

Ohio Dept of Insurance

State Vision Professionals Board

Ohio Dept of Public Safety

OPOTA

Occupational Therapy, Physical Therapy & Athletic Trainers Board

Ohio Dental Board

Other

Address for results to mailed to if "Other" selected above?

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