Partner Collection Program Form
Thank you for your interest in becoming a partner with us. Please fill out the form and we will contact you once we review your submission.
Applicant Name
*
First Name
Last Name
Applicant Job Title
*
Role in Company
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Company Name
*
Facility Name if different from company name
Company Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Does your company have a website?
*
Yes
No
If yes, what is the company website?
Do you have other locations you are interested in providing fingerprinting services?
Yes
No
Type of Business
*
Primary products/services offered
What characteristics makes your business an ideal partner?
*
0/30
How many years has your company been in business?
*
Company Location
*
Please Select
Stand alone storefront
Shopping plaza
Warehouse
Shared office space
Other
geographical environment
If other, please specify
geographical environment
Hours of Operation
*
When are you open to your customers?
Are walk-ins welcome?
*
Yes
No
Average weekly foot traffic?
*
Is public parking available?
*
Yes
No
Total number of employees?
*
Number of employees to become trained fingerprint technicians?
*
Please note: All fingerprint technicians must be able to clear a criminal background check
Where do you intend to conduct the fingerprint captures?
*
Please note: the Live Scan machine requires the space of an average sized-desk, with room for the fingerprint technician and customer.
Submit
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