Background Check Information

Only the student must fill out this form. Please fill out all information accurately.

Profile ID Number*
Student's Legal First Name*
Student's Legal Last Name*
Current Street Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Previous Street Address (if any)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
How long did you live there?
Social Security Number*
International YAs, just enter 000-00-0000
Date of Birth*

(mm/dd/yyyy. Example: March 12, 1996 = 03/12/1996)
Passport Number*
Upload an image or scan of the main page of your passport.*
Accepted file types: jpg, gif, pdf.
Scanned images are preferred; we will accept a photo of your passport, however, the picture must be clear, the image must be large enough to read, and all text must be completely legible. Acceptable file types for uploading are .jpg, .gif, .pdf
Comments
This field is for validation purposes and should be left unchanged.