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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/MAIII initial or reactivation form
  1. 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 are to use the standard FBI Applicant card (FD-258) for fingerprints.

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

  • Last Name, First Name, Middle Name
  • Signature of Person Fingerprinted (Your Signature)
  • Aliases/AKA
    • Maiden Name
    • Other names used by you
    • Insert N/A if you have none
  • Date of Birth
  • Residence of Person Fingerprinted (your home address)
  • Citizenship (US or other country)
  • Sex
  • Race
  • Height
  • Weight
  • Eyes (color)
  • Hair (color)
  • Place of Birth
  • Date (date prints taken)
  • Signature of Official taking Fingerprints
  • Social Security Number

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

  1. Submit the following to North Dakota Board of Nursing (NDBON)
  • Criminal History Record Check 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
    • Do not fold fingerprint cards
  • Money Order or Cashier Check for $40, with a current date, and must be made PAYABLE TO BCI (no personal checks accepted).
  1. NDBON will submit completed form, fee, and fingerprint card 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.

 

North Dakota Board of Nursing
919 S 7th St, Suite 504
Bismarck, ND 58504-5881
Telephone:  701-328-9780

Revised 05/17

Frequently Asked Questions about CHRC