You have been directed to this site for payment of your student background screening. You only need to complete the items below if you are making payment on-line.

 

ALL STUDENTS MUST MAIL OR FAX THEIR COMPLETED AUTHORIZATION FORM.

 

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STEP #1 - REGISTRATION

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College or Program Name ATI Clemson University FURMAN Greenville Technical College Greenville Technical College- Continued Education Mary Black School of Nursing OTHER Please Select

College Program Please select AHS - Allied Health BIO - Biological Sciences CSL - Counseling CNA - Certified Nursing Assistant CVT - Cardiovascular Technology DAT - Dental Assisting DHG - Dental Hygiene DMS EMS - Emergency Medical Services EMS - Paramedic HIM - Health Info Management INT - International MED - Medical Assistant MLT - Medical Lab Technology MRC - Medical Record Coder NMT - Nuclear Medicine Technology NUR - Nursing PHM - Pharmacy PHS - Public Health Sciences PTA - Physical Therapist Assistant PTH - Massage Therapy RAD - Radiological Technician RES - Respiratory Care SUR - Surgical Technician THR - Therapeutic Recreation

Student Name

Name on Credit Card

Address

City, State & Zip ,

Contact Phone #

E-mail Address

Message

All students MUST submit a completed Authorization form,

How will you be sending in your form? By Mail By Fax Select