"Livingstone College Police Record Check"
Print Form Livingstone College Police Record Check To maintain our safe campus community, it is mandatory that you submit the Police Record Check form by May st. Please attach an official copy of your Police Record Check to this form. You should obtain your record check from the Clerk of Court's office in your city 31 of permanent residence. PLEASE NOTE RESIDENTS OF CA, MD, NY, PA, AND VA SHOULD ALLOW 4-6 WEEKS FOR THE CLERK OF COURT TO PROCESS YOUR POLICE RECORD CHECK. The purpose of the Police Record Check is to ensure the safety of all students enrolled at Livingstone College by rescinding the offer of admission to those applicants with prior arrests and/or convictions for violations of the law. You must complete and submit this form in order to enroll at Livingstone College. Part I (To be completed by applicant) Last Name First Name MI Permanent Mailing Address City State Zip Social Security Number Phone Number Place of Birth City State Date of Birth Gender Citizenship (if other than U.S.) If citizenship is other than U.S., indicate visa status Part II: Please attach an official copy of your Criminal Record Check to this form Office of Admission701 West Monroe StreetSalisbury, NC 28144-5298Fax 704.216.6215 Revised 13-Jan-06