LOUISIANA STATE BOARD OF NURSING
17373 Perkins Road
Baton Rouge, Louisiana 70810
Telephone (225) 755-7500 Fax: (225) 755-7580
APPLICATION FOR PERMISSION TO ENROLL IN CLINICAL NURSING COURSES OR
FOR INITIAL LICENSURE BY EXAMINATION MUST BE ACCOMPANIED BY
FINGERPRINT CARDS AND FEE AS FOLLOWS:
1. Complete and sign the Authorization for Criminal Background Check (CBC) form.
* Please copy each page of the Authorization for Criminal Background Check (CBC) form
on front of separate page.
DO NOT PRINT DOUBLE SIDED
You may obtain cards at Law Enforcement Agencies. However, the Cards must have
demographics on the front.
OUT OF STATE EXAM APPLICANTS -- You may download the forms from LSBN
website under “EDUCATION” and request cards from LSBN or obtain cards at Law
Enforcement Agencies. However, the Cards must have demographics on the front.
2. Contact your campus security or local police/sheriff’s office, or an office of the state police to
inquire about procedures for completion of fingerprint cards. They may specify a particular
location, time and fee for fingerprinting. Take both cards to the designated location.
Each of the two (2) FBI cards need a separate and distinct set of your fingerprints. If the
agency utilizes an electronic scan system, request that they scan your fingerprints and print
the first FBI card, then scan your fingerprints again and print the second FBI card.
If you’ve experienced problems in the past with fingerprinting or obtaining a CBC report,
advise the officer/technician before they print you. The following suggestions may improve
Hands must be clean and dry. Wash your hands vigorously with warm water and dry
thoroughly immediately prior to being fingerprinted.
If hands are very dry or cracked, wash hands and apply a touch of moisturizer onto
fingertips, removing any excess lotion with paper towel prior to being fingerprinted. This
may help raise the ridges for printing.
*MUST HAVE 2 DIFFERENT FINGERPRINTS- DO NOT SUBMIT 2 COPIES
OF SAME PRINT.
3. Return the two (2) completed cards, required fee and authorization forms to the office of your
program head. Do not fold or staple the cards.
4. Fee for fingerprint record check is $40.75 by money order made payable to the Louisiana State
Board of Nursing.
5. The criminal history record information checks are authorized under the Nurse Practice Act,
Louisiana Revised Statutes 37:920.1 and are required as part of the permission to enroll in
clinical nursing courses process.
6. The permission to enroll may not be delayed awaiting these reports; however, future action may
result if the criminal history record information so indicates.
Revised Updated: 2/19/2008 02/07/2011. 9/8/11, 2/9/12, 1/5/15, 1/22/16, 7/25/16PAD