Skip navigation

Forms

The Minnesota Department of Education is in the process of updating our forms to fillable PDF forms. Forms can then be filled out electronically and saved, or printed and filled out manually, if need be.

Some forms will be updated in the coming weeks; some will be kept as is until their next revision date. If you have questions about forms completion, please contact the person listed for each individual form.

Sort by Title, Due Date, Program Area, Charter School or Due Date by clicking on the heading below:

Title
Due Date
Contact
Program Area
Charter School
Form #
Appeal of End-of-Year FY 2013 MARSS Data
Roxann Neu
651-582-8486
School FinanceED-02451-05
Application for Duplicate License or Name Change Authorization
This form has been updated and can be used to request either a copy of your Minnesota license or to authorize a name change to your License Record. Please read, complete, and include all documents required before mailing the form.

651-582-8691
Educator LicensingNo
Application for EDRS (Electronic Data Reporting System) Access
Steve Collins
651-582-8467
School Finance
Application for funds support services for deaf and hard-of-hearing adults
Use this form to request funds for interpreter and notetaker services for deaf and hard-of-hearing adults
Paula Palmer
651-582-8737
Career Tech Ed/Community Ed/Service Learning01643-14
Application for Student Transportation Reimbursement - Open Enrollment and Charter School Enrollment Programs
Kelly Wosika
651-582-8855
School Finance
Application for Student Transportation Reimbursement - Open Enrollment and Charter School Enrollment Programs
Kelly Wosika
651-582-8855
School Finance
Application for Student Transportation Reimbursement - Postsecondary Enrollment Options Program
Kelly Wosika
651-582-8855
School Finance
Application for Student Transportation Reimbursement - Postsecondary Enrollment Options Program
Kelly Wosika
651-582-8855
School Finance
Application for Voluntary Surrender of a Standard Education License (Teaching/Administrative/Related Services)
Use this form to surrender a Minnesota license.
Nancy Farvour
651-582-8773
Educator LicensingYesED-01695-09
Application to Add a Field to an Existing Minnesota License
This form has been updated and now can be completed and saved onto a computer. This form MUST be printed and mailed into the Educator Licensing. Electronic signatures are NOT accepted.
Educator Licensing
651-582-8691
Educator LicensingED-02443-12
Capital Expenditure Disabled Access Revenue Levy Authority Application
Chris Kubesh
651-582-8319
School FinanceED-02081-20
Charter School Transportation Survey 2014-15 School Year
2014-03-01Kelly Wosika
651-582-8855
School FinanceYesED-02425-08
Child and Adult Care Food Program (CACFP) Agreement
Food and Nutrition Service
651-582-8698
Child/Adult Care ProgramsNoED-02409-04E
Community Education Annual Report
An annual report for each school district having a community education levy.
Michelle Kamenov
651-582-8434
00226-26
Concurrent Enrollment Aid Application 2013-2014
High schools that are partnering with postsecondary institutions NOT accredited by the National Alliance of Concurrent Enrollment Partnership (NACEP) or in the process of becoming accredited must complete this application in order to receive concurrent enrollment aid. Applications are due by March 28, 2014.
2014-03-28Jacqui McKenzie
651-582-8852
Hg Sch/DualCred/Alt/OnlineLrngED-02456-03
County Auditor Report of School District Apportionment
Jan Carlson
651-582-8342
School FinanceED-00016-18
Determining Resident District
Sharon Peck
651-582-8811
School FinanceYesED-02457-01
District Revenues and Expenditures Budget for FY 2014 and FY 2015
Sarah Miller
651-5828370
School FinanceED-000110-37
District-Owned School Bus Transaction
Kelly Wosika
651-582-8855
School FinanceED-00186-13
District-Owned Special Education School Bus Transaction
Kelly Wosika
651-582-8855
School FinanceED-02387-04
District-Owned Special Education Type III School Bus Transaction
Kelly Wosika
651-582-8855
School FinanceED-02388-04
District-Owned Type III School Bus Transaction
Kelly Wosika
651-582-8855
School FinanceED-01658-11
Early Childhood Family Education and School Readiness Participant Questionnaire - English

Early Childhood Family Education Annual Report (Worksheet)
The Early Childhood Family Education (ECFE) Annual Report form is a worksheet to prepare data for electronic submission to the Early Learning Services Data System. These data are about ECFE program particiaption and services during the school year.
2012-07-15Debbykay Peterson
651-582-8426
Early Childhood ServicesED-2309-12
Early Childhood Family Education Annual Report Worksheet (ED 01843-29)
The Early Childhood Family Education (ECFE)Annual Report is a worksheet to prepare data for electronic submission to the Early Learning Services Data System. These data are about ECFE program participation and services during the school year.
2012-07-15Debbykay Peterson
651-582-8426
Early Childhood ServicesNo01843-29
Early Childhood Family Education Participant Questionnaire Summary
Form to assist school districts in the preparation of aggregated Early Childhood Family Education participant demographic data for electronic submission to Minnesota Department of Education.
2012-07-15Debbykay Peterson
651-582-8426
Early Childhood ServicesED-2309-12
Early Childhood Screening Annual Report (Worksheet)
The Early Childhood Screening Annual Report form is a worksheet to prepare data for elctronic submission on the Early Childhood Screening program participation and services during the school year.
2012-07-15Sophie Oliver
651-582-8307
Early Childhood ServicesED-2309-12
Enrollment Options Program Limited Enrollment of Non-Resident Pupils Report
ED-02226-06
2012-07-15Cindy S. Jackson
651-582-8572
YesED-02226-06
Enrollment Projections Report - School Year 2013-14
For Charter Schools within their first three years of operation.
Jeanne Krile
651-582-8637
School FinanceYesED-02158-24(A)
Enrollment Projections Report - School Year 2014-15
For Charter Schools within their first three years of operation.
Jeanne Krile
651-582-8637
School FinanceYesED-02158-24(B)
Enrollment Projections Report - School Year 2015-16
For Charter Schools within their first three years of operation.
Jeanne Krile
651-582-8637
School FinanceYesED-02158-24(C)
Federal Funding for Preschool Special Education
George Holt
651-582-8889
School FinanceED-02465-01
FY 2010 Special Education Federal Unspent Funds
George Holt
651-582-8889
School FinanceED-02465-01
General Expenditure Worksheet II-B Special Education Personnel and Expenditures
Michelle Jones
651-582-8577
School Finance
Home Language Questionnaire
Sample questionnaire in English. For the questionnaire in languages other than English, please contact mde.el@state.mn.us
Anh Tran
YesED-01336-08E
Interscholastic and Intramural Athletic Activities Worksheet
This form is used to report male and female elementary and secondary athletic activities information as required by Minnesota Rules, Part 3535.3600. For district files only. Do not return to MDE.
2011-10-15Sara Winter
651-582-8237
Compliance & MonitoringYesED-02307-02
Invoice for Educational Services for Students in Care and Treatment
George Holt
651-582-8889
School Finance
Letter of Intent to Continue to Provide Instruction
This form is to be submitted to the resident school superintendent by October 1 of each year after the instructor has provided the same district with a Full Report. Revised July 2012.
2012-10-01Cindy S. Jackson
651-582-8572
No
Monthly Transportation Reimbursement Request - Open Enrollment and Charter School Enrollment Programs
Kelly Wosika
651-582-8855
School FinanceED-01876-25
Monthly Transportation Reimbursement Request - Postsecondary Enrollment Options Program
Kelly Wosika
651-582-8855
School FinanceED-01765-28
Nonpublic Fall Report - 2013-14
Carol Hokenson
651-582-8840
School FinanceED-00027-37
Online Learning Option Act Provider Application
Application process to gain MDE approval of becomming an online learning provider in Minnesota.
Deborah Proctor
651-582-8328
Hg Sch/DualCred/Alt/OnlineLrngED-02334-07
Online Learning Program Annual Update
Form to be completed by approved online learning providers and submitted to the Online Learning Specialist by July 15.
Deborah W. Proctor
651-582-8328
Hg Sch/DualCred/Alt/OnlineLrngED-02444-05
Online Learning Supplemental Notice of Student Registration Form
Form for student to submit to apply for a supplemental online learning course from a MDE approved public school online learning provider.
Deborah W. Proctor
651-582-8328
Hg Sch/DualCred/Alt/OnlineLrngED-02400-05
Postsecondary Enrollment Options Program Notice of Student Registration
Form to be completed providing notice of student registration in Postsecondary enrollment options program.
Carol Hokenson
651-582-8840
School FinanceED-01763-14
Program Aid Approval for First Year Charter Schools (FY 2014)
Michelle Jones
651-582-8577
School FinanceED-02371-08
Pupil Transportation Annual Report
Kelly Wosika
651-582-8855
School FinanceED-01652-32
Qualified Zone Academy Bond Program Application
Chris Kubesh
651-582-8319
School FinanceED-02243-04
Reallocation of Federal Special Education Funds
George Holt
651-582-8889
School FinanceED-02465-01
Request for Fund Transfer
David Day
651-582-8384
School FinanceED-02462-02
Request for FY 2014 Coordinated Early Intervening Services (CEIS)
Michelle Jones
651-582-8577
School FinanceED-02466-02
Request for FY 2014 Federal Funds for Special Education Tuition Adjustment
Michelle Jones
651-582-8577
School FinanceED-02448-05
School District Credit Enhancement Application for Program Participation
Sarah Miller
651-5828370
School FinanceED-02110-06
School Readiness Annual Report (Worksheet)
The School Readiness Annual Report form is a worksheet to prepare data for electronic submission to the Early Learning Services Data System. These data are about School Readiness program participation and services during the school year.
2012-07-15Debbykay Peterson
651-582-8426
Early Childhood ServicesED-2309-12
School Readiness Participant Questionnaire Summary
Form to assist school districts in the preparation of aggregated School Readiness participant demographic data for electronic submission to Minnesota Department of Education.
2012-07-15Debbykay Peterson
651-582-8426
Early Childhood ServicesED-2309-12
School Readiness Program Plan (2013)
School Readiness Program Plans are required to be submitted biennially by school districts to the Minnesota Department of Education. The Plan describes how a program meets School Readiness program requirements.
2013-04-01sophie Oliver
651-582-8307
Early Childhood ServicesED-02353-07
School Readiness Program Plan (Worksheet)
Guidelines and worksheet forms to prepare data for electronic submission. The school Readiness Program Plan is required for school districts to receive School Readiness Aid.
2012-07-15Debbykay Peterson
651-582-8426
Early Childhood ServicesED-2309-12
School Tax Abatement Report for Calendar Year 2013
Due February 1, 2014
Jan Carlson
651-582-8342
School FinanceED-02009-25
School Tax Abatement Six-Month Supplemental Report
Jan Carlson
651-582-8342
School FinanceED-02124-20
School Tax Report - 2013 Payable 2014
Jan Carlson
651-582-8342
School FinanceED-00119-38
Secondary Career and Technical Education Program Approval Proposal for Youth with Disabilities
Program Approval Proposal may be completed and submitted to Adult and Career Education at any time during the school year. The proposal will be reviewed per Minnesota State Rules and you will be notified of action taken.
Paula Palmer
651-582-8737
Career Tech Ed/Community Ed/Service LearningED-00381-15
Secondary Career and Technical Education Transition Disabled Equipment Approval Request.
This application provides for necessary equipment to develop occupational competencies in an approved instructional program for students with disabilities.
Al Hauge
651-582-8409
Career Tech Ed/Community Ed/Service LearningED-00365-17
Special Education Application Court Placed Non-Minnesota Residents With Individual Education Programs (IEPs) 2013-2014
(ED-02432)
George Holt
651-582-8889
School FinanceED-02432-08
Special Education Application Out-of-State Tuition for Minnesota Residents 2013-2014
(ED-02431)
George Holt
651-582-8889
School FinanceED-02431-08
Special Education Application Special Pupils With Individual Education Programs (IEPs) 2013-2014
(ED-02433)
George Holt
651-582-8889
School FinanceED-02433-08
Special Education Application Special Pupils Without Individual Education Programs (IEPs) 2013-2014
(ED-02434)
George Holt
651-582-8889
School FinanceED-02434-08
Special Education Out-of-State Travel Request
(ED-02474)
George Holt
651-582-8889
School FinanceED-02474-01
Special Expenditure Worksheet II-C Individual Student Placements
Michelle Jones
651-582-8577
School Finance
Statewide Enrollment Options
Enrollment Options/Open Enrollment Form
2014-01-15Cindy S. Jackson
651-582-8572
YesED-01861-23
Student Transportation Reimbursement Report - Open Enrollment and Charter School Enrollment Programs
Kelly Wosika
651-582-8855
School Finance
Student Transportation Reimbursement Report - Open Enrollment and Charter School Enrollment Programs
Kelly Wosika
651-582-8855
School Finance
Student Transportation Reimbursement Report - Postsecondary Enrollment Options Program
Kelly Wosika
651-582-8855
School Finance
Student Transportation Reimbursement Report - Postsecondary Enrollment Options Program
Kelly Wosika
651-582-8855
School Finance
Summer Food Service Program Agreement
Agreement for sponsors of summer food service programs.
Jenny Butcher
651-582-8543
School Nutrition ProgramsNoED-02372-04E
Taconite Credit Report
Jan Carlson
651-582-8342
School FinanceED-02331-11
Title III Intent to Form a Consortium
This document must be completed and submitted to MDE by districts intending to form a Title III Consortium.

Transition Disabled Contracted Services Approval Request Form
Complete this report when funding is being requested for contracted services associated with a career and technical education (CTE) program for students with disabilities.
Al Hauge
651-582-8409
ED 01445
Transportation to Interdistrict Desegregation or Integration Schools or Programs
Kelly Wosika
651-582-8855
School FinanceED-02370-08
UFARS Code Request
Sarah Miller
651-582-8370
School FinanceED-02093-04
Unaccredited Nonpublic School (Including Homeschools) Full Report
This form is to be submitted to resident school superintendents by October 1 of each year, or within 15 days of withdrawing a child from public school. Revised July 2012.
2012-10-01Cindy S. Jackson
651-582-8572
No
Uniform Tuition Billing Invoice for Transition Services
Michelle Jones
651-582-8577
School Finance
Uniform Tuition Billing One-to-One Services - 2013-2014 School Year
Jeanne Krile
651-582-8637
School FinanceED-02424-08
 
 
 
  • Copyright 2012
  • Minnesota Department of Education