Electronic Grants Management System (EGMS) Institution Request Form

This form is being used to replace the Institution Request Form for those receiving grants through the Oregon Department of Education. This form should only be completed if your institution does not have an Institution ID. If you believe you have an Institution ID, you can search for it on the Institution Lookup Tool. All sections of this form must be completed entirely. Failure to complete each section or provide any additional required documentation will delay the processing of your request. For questions about this form contact Amanda Leopard at ode.institutions-request@ode.oregon.gov. For questions about your grant, contact your grant manager.

We recommend you take the time to set up Direct Deposit for your grants. To do so, complete a Direct Deposit Authorization Form.

Today's Date*

Requests will be processed in the order they were submitted.

Institution ID

If you are requesting a change to a current institution, please provide your institution ID. If you do not know your ID, but know you have done business with ODE previously and believe you have an ID, you can locate it on the Institution Lookup Tool.

Requested Change*

If you have an ID for your institution, briefly explain what change you are requesting on this form or why you are using this form. Changes can be address, contact information, etc.

Institution Sector*

Select Public, Private, or Private Non-Profit.

Select

Grant Name

Please provide the name of the grant you are receiving. If you don't know what grant you are receiving, please include the name of the person at ODE that you are working with for your grant.

Grant Manager Information*

Please provide the name of the person at the Oregon Department of Education that you have been in contact with regarding your grant. If you have their e-mail you may also include it here.

Legal Institution Name*

Provide the legal institution name as listed with the IRS.

Institution Name (Doing Business As)

ONLY provide this if the Institution Doing Business As name is something different than the legal name.

Street Address*

Provide the physical location of the institution. Include a full address with city, state, and zip. (e.g. 255 Capitol St. Salem, OR 97310).

Mailing Address

ONLY provide a mailing address if it is different than the street address of the institution. Include a full address with city, state, and zip. (e.g. 255 Capitol St. Salem, OR 97310).

Phone Number*

Provide the institution's main contact phone number (e.g. 503-947-5600).

Fax Number

Provide the institution's main fax number if applicable (e.g. 503-378-5156).

E-mail Address*

Provide the institution's main contact e-mail address (e.g. ode.institutions-request@state.or.us).

Website Address

Provide the institution's website home page address if applicable (e.g. https://www.oregon.gov/ode/).

Employee Information

This information is stored in the Institution Database and these will be the contacts listed on your grant.

Institution Head - Name*

Provide the first and last name of the person considered the head of your institution.

Institution Head - Email Address*

Provide the e-mail address of the person considered the head of your institution (e.g. amanda.leopard@state.or.us).

Institution Head - Phone Number*

Provide the phone number of the person considered the head of your institution (e.g. 503-947-5600).

Required Attachments

The EGMS Access Request Form and a W9 are required for you to get a user login to the Electronic Grant Management System (EGMS) to make claims on your grant.

Attachments*

Attach a completed EGMS Access Request Form and W9 here. On the W9, DO NOT include a social security number on this document, instead write “Using SSN” in the "Federal Employer Identification Number" field.

These documents are a requirement for access to grants. The ID field on the EGMS Access Request Form may be left blank upon submission. Physical signatures are required for EGMS Access forms.

Non-profit organizations must also provide a Letter of Determination from the IRS which verifies your non-profit status.

Direct questions about these documents to ode.egms@ode.oregon.gov.

Failure to provide completed required documentation will result in a delay in processing your request which can delay the process for receiving your grants.

Drag and drop files here or

Submitter's Name*

The name of the person submitting this form. It is not a requirement that the person completing the form be the institution's head, however the person submitting the form assumes responsibility for the information provided.

Submitter's Email Address*

The e-mail address of the person submitting this form. This will be used to contact the submitter with any questions, or to provide the Institution ID number once approved.

Send me a copy of my responses

Privacy Notice|Report Abuse