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MD-BSWE – LIVESCAN PRE-REGISTRATION APPLICATION – 2019
MARYLAND
Department of Health
LBSW & LGSW BY EXAMINATION
CJIS – CRIMINAL JUSTICE INORMATION SYSTEM
AND
CHRC – CRIMINAL HISTORY RECORDS CHECK
I FOR APPLICANTS WHO RESIDE IN MARYLAND:
1) LIVESCAN PRE-REGISTRATION FORM – LOCATED ON THE NEXT PAGE
2) TAKE THIS FORM TO A FINGERPRINTING LOCATION IN MARYLAND
3) DO NOT MAIL THIS FORM TO THE BOARD OF SOCIAL WORK
4) DO NOT SEND ANY RECEIPTS TO THE BOARD OF SOCIAL WORK
5) THE BOARD RECEIVES THE CHRC ELECTRONCIALLY AND DIRECTLY FROM CJIS
FOR FAST AND ACCURATE SERVICE
1. If you are requesting a background check for licensing purposes you must use the Maryland
Board of Social Work Examiner’ name and authorization numbers, listed below:
CJIS #1300005486 & FBI ORI – MD920513Z
2. If your background check is being sent to a government agency you may also need an ORI
number.
3. You must bring a valid form of government identification. (Examples: driver's license,
Certificate of Naturalization, passport, Alien Registration Card, or Military Identification)
4. Take the Livescan Pre-registration Application to any fingerprinting center.
5. Bring payment: major credit cards, checks, and money orders are accepted. Cash is not
accepted at the State Operated Fingerprinting Centers.
Government Operated Services: The fee is $31.25 for a full background check State and FBI.
Commercial Fingerprinting Services (Private Providers): The fee is $30.00 plus an additional
amount set by the private provider.
For a listing of providers, both State and Private please go to
http://www.dpscs.maryland.gov/publicservs/fingerprint.shtml
II FOR APPLICANTS WHO DO NOT RESIDE IN MARYLAND:
1) Send an Email message, Deborah Evans, Licensing Coordinator
Deborah.Evans@maryland.gov
2) Provide your legal name and mailing address.
3) A fingerprint card will be mailed to you with an envelope addressed to CJIS.
4) DO NOT MAIL THE COMPLETED FINGERPRINT CARD TO THE BOARD
MARYLAND BOARD OF SOCIAL WORK EXAMINERS
4201 Patterson Avenue, Baltimore, Maryland 21215 – 2299 www.health.maryland.gov/bswe/
Phone Number: 410-764-4788 Fax Number: 410-358-2469 Toll Free: 1-877-526-2541