After reviewing the instruction below, please review our CHRC Checklist document (available by clicking here), to ensure accuracy.

1. Submit an application
   
2. Contact your local law enforcement agency or a private agency that provides fingerprinting services to make an appointment to be fingerprinted
   • Fee for fingerprinting will vary depending upon agency charges
   • Agencies and law enforcement must use the standard FBI Applicant card (FD-258) for fingerprints
3. Download and complete the Criminal History Record Check form available by clicking here (includes SFN 60688 and 62550)
   • Complete the last section titled “To be Completed by Subject of Record Check” only
   • Sign and date the form
   • Completed fingerprint cards (from the law enforcement agency/private agency)
   • TWO completed fingerprint cards if ink and roll
   • ONE completed fingerprint card if electronic (electronic means the fingerprints are electronically scanned and printed onto the fingerprint cards. Applicants are still required to mail in the hard copy of the fingerprint cards)
   • Do not fold fingerprint cards
   • Money Order, Cashier Check, or personal check for $40.00, with a current date, and must be made payable to ND Attorney General
4. Mail the completed packet to the North Dakota Board of Nursing

   North Dakota Board of Nursing
   919 S 7th Street, Suite 504
   Bismarck, ND 58504

Note: NDBON will submit the completed form, fee, and fingerprint cards to Bureau of Criminal Investigations (BCI).

• BCI will return the background check results to NDBON
• If fingerprints are rejected by BCI, NDBON will notify the applicant

• Last Name, First Name, Middle Name
• Last Name, First Name, Middle Name
• Signature of Person Fingerprinted (Applicant’s Signature)
• Aliases/AKA (Do Not Leave Blank)
  • Maiden Name
  • Other names used by applicant
  • Insert N/A if you have none
• Date of Birth (MM/DD/YYY format)
• Residence of Person Fingerprinted (applicant’s physical residence NOT mailing address)
• Citizenship (US or other country)
• Sex (M for male; F for female)
• Race
  • A – Asian/Pacific Islander
  • B – Black/African American
  • I – American Indian or Alaskan Native
  • W – White or Hispanic
  • U – Unknown
• Height (Enter in feet & inches. Example – if 5 feet 7 inches tall enter 507; if 5 feet 10 inches tall enter 510)
• Weight (in pounds)
• Eyes (color-use color code below)
• Hair (color-use color code below)
• Place of birth (If in US, use 2 letter state abbreviation. If foreign country enter full name)
• Date (date prints taken)
• Signature of Official Taking fingerprints
• Reason Fingerprinted (clearly state “license/registration” for which applicant is applying)
• Social Security Number