For LEA/PSA/ISD District Users:

The following forms may be typed online using Adobe Acrobat Reader (see below) and then printed. If forms are incomplete or illegible, processing time may be delayed. Fax completed and signed forms to CEPI at (517) 335-0488 (as indicated on the forms).

The following security agreement form is for staff members of local education agencies, public school academies, and ISD-operated school districts/facilities who will need to access the SRSD/UIC Application to resolve potential duplicate student records, and/or manage SRSD/UIC authorized user accounts within their LEA/PSA/ISD districts.

LEA/PSA/ISD District SRSD/UIC Application Security Agreement

For Intermediate School District Users Only:

The following security agreement form is for staff members of intermediate school districts who will need to access the SRSD/UIC Application to upload SRSD files, Audit FTEs, and view potential duplicate student records within their ISD and constituent districts.

Intermediate School Districts SRSD/UIC Application Security Agreement

Use the link below to access the Removal Request Form for CEPI and MDE applications.

Removal Request Form

These forms require Adobe Acrobat Reader.