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4. Overview

Criminal History Record Check (CHRC) Instructions

1. Submit an online RN or LPN initial application by exam or endorsement OR include one of the following forms:

• An RN or LPN Reactivation form or;
• An initial APRN application or;
• A UAP/Technician/MA III initial or reactivation form

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 are to use the standard FBI Applicant card (FD-258) for fingerprints

3. NOTE: Mail the CHRC form directly to the North Dakota Board of Nursing (NDBON); 919 S 7th Street, Suite 504; Bismarck, ND 58504

• Criminal History Record Check form available by clicking here.
  • 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 or Cashier Check for $41.25, with a current date, and must be made payable to the ND Attorney General (no personal checks accepted)

4. 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 you

Required fields to be completed at the top of the fingerprint cards using BLACK ink:

• Last Name, First Name, Middle Name
• Signature of Person Fingerprinted (Your Signature)
• Aliases/AKA (Do Not Leave Blank)
  • Maiden Name
  • Other names used by you
  • Insert N/A if you have none
• Date of Birth (MM/DD/YYY format)
• Residence of Person Fingerprinted (your 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 you are applying)
• Social Security Number

*IF FINGERPRINT CARDS ARE INCOMPLETE YOU WILL BE REQUIRED TO SUBMIT NEW CARDS

Eye and hair color codes

BAL     Bald
BLK     Black
BLN     Blond or Strawberry
BLU     Blue
BRO    Brown           
GRY    Gray            
GRN    Green
HAZ     Hazel
MAR    Maroon
MUL    Multi-colored
ONG   Orange
PLE     Purple
PNK     PInk  
RED     Red
SDY     Sandy
WHI     White

2/1/22