Livescan Fingerprinting XPress Registration

Maryland Science Center

Saturday, January 24, 2026 @ 9:00 A.M.

Applicant Background Check for Child Care

Instructions: Please complete all sections of the pre-registration form, carefully review your entries and then click “Submit” to complete your pre-registration. All pre-registrations are due no later than 4:00 P.M. on Thursday, January 22, 2026. For any questions about this event, please contact Lindsey Marotta @ lmarotta@mdsci.org.

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Child Care Registration

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Mobile Date & Time:

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ORI Code

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Authorization Code

Name*

First Middle Last Suffix

Date of Birth*

Sex*

Race*

Height*

You must enter 2 digits for inches, ex: 5'03 for 5 foot 3 inches.

Weight*

Eye Color*

Hair Color*

Were you born in the United States?*

Yes

Place of Birth

Country of Birth

Country of Citizenship*

Address*

Street Address City State ZIP Code

Phone*

Email*

Enter Email Confirm Email

Disclosure Statement: (Selection Required)*

I hereby declare and affirm under the penalties of Perjury, that I

HAVE NOT been convicted, received a probation before judgment, received a non criminally responsible disposition, and AM NOT the subject of pending criminal charges. I further declare and affirm I am the above named person making this statement.

HAVE NOT been convicted, received a probation before judgment, received a non criminally responsible disposition, and AM the subject of pending criminal charges. I further declare and affirm I am the above named person making this statement.

HAVE been convicted, received a probation before judgment, received a non criminally responsible disposition, and AM NOT the subject of pending criminal charges. I further declare and affirm I am the above named person making this statement.

HAVE been convicted, received a probation before judgment, received a non criminally responsible disposition, and AM the subject of pending criminal charges. I further declare and affirm I am the above named person making this statement.

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CJIS Number