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Transcripts
Michigan Online Employment System
Menu
1
Application
2
Drivers License
3
Drug Screen
4
Criminal Records Release
5
Conviction Disclosure
6
Job Description
7
Policies & Procedures
8
Corporal Punishment
9
Unprofessional Conduct
10
Registry of Personnel
11
Cell Phone Usage
12
Payroll Deductions
13
Direct Deposit
14
Healthcare Enrollment
15
Fingerprint Waiver
16
Michigan W-4
17
USCIS I-9
18
IRS W-4
19
Fingerprints Release
20
Transcripts
Registry of Educational Personnel
Information requested on this form is used by school districts with their hiring in REP (an online government database) to produce school personnel reports for the U.S. Department of Education and the State of Michigan.
Personnel Information
Full Name
(Required)
First
Middle
Last
Email Address
(Required)
Use the same email on all forms.
Cell Phone
(Required)
Use the same cell phone on all forms.
Address
(Required)
Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Social Security #
(Required)
Date of Birth
(Required)
MM slash DD slash YYYY
Position
(Required)
Teaching Credential License Number
Demographic Information
Gender
(Required)
Male
Female
Other
Race
(Required)
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
White
Other
Highest Education Level
(Required)
No High School Diploma or Equivalent
High School Diploma or Equivalent (e.g., GED)
Some College, No Degree
Associate Degree (e.g., AA, AS)
Bachelor's Degree (e.g., BA, BS)
Master's Degree (e.g., MA, MS, MEd)
Professional Degree (e.g., MD, DDS, DVM)
Doctorate Degree (e.g., PhD, EdD)
Other
Academic Information
Name of College or University
(Required)
Year Completed
(Required)
Agreement
Consent
(Required)
By submitting this form, I hereby acknowledge and agree that the information provided will be entered into the REP (Registry of Educational Personnel) online database and may be used to produce school personnel reports for the U.S. Department of Education and the State of Michigan.
I understand that the collected data will be used in compliance with all applicable laws and regulations, including but not limited to the Family Educational Rights and Privacy Act (FERPA), and will be stored securely to maintain confidentiality.
I further understand that providing this information is voluntary and that I have the right to decline to provide this information. I verify that the information I have provided is accurate and true to the best of my knowledge.
I understand and agree
(Required)
Signature
(Required)
Use the box below and sign your name.