EASI Application Access Request Form (Previous Applications)

EASI Application Access Request Form (Previous Applications)

Applicant Information

School District / BOCES / Charter School Name

Charter Schools should connect with their authorizer to confirm that they will submit an application apart from the authorizer.

LEA / BOCES / Charter School 4-Digit Code*

Enter if known, but not required. School and district codes can be found on CDE's website at http://www.cde.state.co.us/datapipeline/org_orgcodes .

If Charter School, Name of Authorizer

Charter School Institute or name of School District

Please indicate which Cohorts you need access to*

Select or enter value

Primary Contact Name*

Primary Contact Title*

Primary Contact Phone Number*

Primary Contact E-mail Address*

E-mail addresses will be used as the login username, so ensure that it is correct.

Secondary Contact Name

Secondary Contact Title

Secondary Contact Phone Number

Secondary Contact E-mail Address

E-mail addresses will be used as the login username, so ensure that it is correct.

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