Secure Submission Portal

Background Check Request

Please complete all required information and upload clear images of the applicant's Social Security Card and Driver's License.

Fields marked with * are required. Please review all information before submitting.

Request Information

Select the club first, then choose the chapter associated with this request.

What club is this request for?

Select what Chapter this is for

Applicant Information

Enter the applicant's legal information exactly as it appears on their identification. Home State is required.

First Name

Middle Name

Last Name

Date of Birth

Social Security Number

Home State

Required Identification

Upload a clear, readable image of each document. JPG, PNG, HEIC, or HEIF. Maximum 10 MB each.

Social Security Card * Make sure the entire card is visible and readable.

Driver's License * Upload the front of the license with all information visible.

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Uploaded documents are stored in a private Google Drive folder controlled by the account running this form. They are not made public or shared by link.

Requester Information

Provide the contact information for the person submitting this request.

Requester Name

Requester Phone Number

Email Address

Background Check Portal

Background Check Request