Live Scan Scholarship

Live Scan Fingerprinting Scholarship Request Form:

Your Name *

First

Last

Your Position:

Your Email *

Your Phone *

Unit Number:

District: *

Unit Coordinator:

First

Last

List of individuals needing assistance: *

Proof of payment upload: *

Click or drag a file to this area to upload.

Name or Unit Account to send reimbursement: *

Address to send reimbursement:

Address Line 1

Address Line 2

City

State

Zip Code