Some state boards of nursing(California, New Mexico, Illinois, Florida, etc) require submission of fingerprint cards (FD-258 FBI card) for criminal background checks, as part of NCLEX application.

Applicants can request for fingerprint cards from their respective state board of nursing, and it’s usually mailed by the board in 2-3 weeks. It’s very important that fields be filled up correctly in BLACK ink. Also, see to it that the card wont be folded, crampled when sending it to state board.

Here are the fields that you need to fill up:

1.   Signature of Person Fingerprinted
Place your signature here.

2.  Residence of Person Fingerprinted
Place your address here.

3. Date
Date fingerprints taken.

4.  Signature of Official Taking Fingerprints
The official taking the fingerprints should
sign.

5. Reason Fingerprinted
License Registered

6. Name  (NAM)
Indicate complete name.

8.  Aliases  (AKA)
Indicate other names used (i.e., maiden
name, nickname and/or alias name[s]).

9.  Date of Birth  (DOB)
Indicate month-day-year of  birth.

10. Sex
Indicate sex code abbreviation.
M=Male  F=Female

11.  Height  (HGT)
Indicate height in feet and inches.

12. Weight  (WGT)
Indicate weight in pounds.

13. Eyes
Indicate eye color abbreviation.

BLK = Black  GRY = Gray  MAR = Maroon
BLU = Blue  GRN = Green  PNK = Pink
BRO = Brown  HAZ = Hazel

14. Hair
Indicate hair code abbreviation.

BAL = Bald  BRO = Brown  SDY = Sandy
BLK = Black  GRY = Gray  WHI = White
BLN = Blond  RED = Red

15.  Place of Birth  (POB)
Indicate the state or country of birth.

16. Social Security No.  (SOC)
Indicate US Social Security number, if any. If you have none, leave this blank.

Here’s a sample of a completed FBI Fingerprint card for NCLEX application in California. Click to enlarge.

fpcard