Do to a high volume of invalid email addresses, we are now requiring an email confirmation be performed. After submitting your application, an email will be sent to the email address you used to register. It will contain a link to validate your account. Until your account is validated, it will NOT be approved.

Interested Party Requesting Search Information Form

Person Requesting Search		First:		Middle:		Last:
		Email:			Create Password:
					Confirm Password:
		Region:	Select Region 1A-Rockford 1B-Peoria 2A-Aurora 3A-Springfield 3B-Champaign 4A-St. Louis 5A-Marion 6A-Chicago 6B-Chicago 6C-Chicago 6D-Chicago	Job Type:	Select Job Type Investigation Specialist Intact Specialist Placement Specialist Investigations Supervisor Intact Supervisor Placement Supervisor Other	Caseworker ID:

Firm or Agency:

Firm or Agency Address:

POS Agency:

Y or N Y N

City:		State:	AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY	Zip Code:		Apt:
Phone Number:		Fax:		Cell:

By requesting search access of the Diligent Search Service Center, you are affirming that you have a valid right to have access to this information.  I certify the above is true After submitting, your application will be forwarded to an agent of the DSSC for review. You will be notified by email if your application was approved or denied.