Fingerprint Registration Form
Fill out this secure form for registration [Protected, Secured, Encrypted Form]
Please verify that you are human
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What type of fingerprinting service do you need?
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INK Fingerprint Card
LIVE SCAN Fingerprints
Other
Full Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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Please enter a valid phone number.
Date of Birth
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-
Month
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Day
Year
Date
Gender
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Please Select
Female
Male
N/A or Unknown
Home Address (no PO Box or business address)
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Country of Citizenship
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USA (United States)
Other
State/Country of Birth
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Height
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Weight
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Eye Color
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BLK: Black
BLU: Blue
BRO: Brown
GRY: Gray
GRN: Green
HAZ: Hazel
Other
Hair Color
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BLK: Black
BRO: Brown
BLN: Blonde
RED: Red
GRY: Gray
BLD: Bald
Other
Race/Ethicity
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(A) ASIAN, including people from the Far East, Southeast Asia, the Indian subcontinent, or the Pacific Islands
(B) BLACK / AFRICAN AMERICAN / AFRICAN, including people with origins in any of the black racial groups of Africa
(H) HISPANIC, including people of Mexican, Puerto Rican, Cuban, Central and South American, Dominican, and other or unknown Latin American or Spanish origin
(I) NATIVE AMERICAN or someone with origins in any of the original peoples of the Americas and maintaining cultural identification through tribal affiliations or community recognition.
(W) WHITE, including people having origins in any of the original peoples of Europe
(U) Unknown or Underminable
ORI Number (N/A if not applicable)
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TCN Number (N/A if not applicable)
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Applicant CRD Number (N/A if not applicable)
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Firm CRD Number (N/A if not applicable)
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What is the reason for your fingerprints (company, department, state, personal, etc)?
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How did you find STARR GLOBAL-FINGERPRINTING?
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Please provide any additional information about you visit that you would like for us to know.
PRIVACY
Please note that our forms and data are secure by default. All information is automatically encrypted and password-protected when transferred. Only STARR GLOBAL SERVICES, LLC - FINGERPRINTING will have have access to your forms and submissions through this portal.
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