California State Soccer Association - South Live Scan Request.pdf

ORI (Code assigned by DOJ) is A2094. Authorized Applicant Type is Non-Profit Organization. Type of License/Certification/Permit is Volunteer. Agency Authorized to Receive Criminal Record Information is California State Soccer Association - South. Mail Code is 09380. Street Address is 1029 South Placentia Avenue. City is Fullerton. State is CA. ZIP Code is 92831. Contact Name is Risk Management Dept. Contact Telephone Number is (714) 451-1518. Last Name is Cal South. First Name is Volunteer. Suffix is None. Other Name Last is None. Other Name First is None. Suffix is None. Date of Birth is None. Sex is None. Male is None. Female is None. Driver's License Number is None. Height is None. Weight is None. Eye Color is None. Hair Color is None. Place of Birth is None. Social Security Number is None. Home Address or P.O. Box is 1029 South Placentia Avenue. City is Fullerton. State is CA. ZIP Code is 92831. Level of Service is DOJ. Original ATI Number is None. Name of Operator is None. Date is None. Transmitting Agency is None. LSID is None. ATI Number is None. Amount Collected/Billed is None. Contact Fax Number is (714) 451-1017. Mobile Phone Number is None. Home Phone Number is None. Email Address is [email protected]. Administrator is None. Club/League Name is None. Referee is None. Referee Association or "New Referee" is None. State is None. Contact Email is None. Middle Name is None. Live Scan Transaction Completed By is None.