Registry Provider Application Form

All applicants to the Public Authority Registry will be required to undergo a Department of Justice Criminal Background Investigation to determine if the applicant has ever been convicted of certain violations of the Penal Code. Applicants who do not โ€œclearโ€ the DOJ check will not be listed on the Registry. The cost for fingerprinting is the applicantโ€™s responsibility (the cost is approximately $70).

Note: An incomplete application will delay processing