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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 #
Annual Report on Curriculum, Instruction, and Student Achievement
Annual Report on Curriculum, Instruction, and Student Achievement
Deborah Luedtke
651-582-8440		School Support
Appeal of End-of-Year FY 2013 MARSS Data
Roxann Neu
651-582-8486		School FinanceED-02451-05
Application for an Addition to a Minnesota Education License (Teaching/Administrative/Related Services)
Use this form to add a field to an existing Minnesota license.
Nancy Farvour
651-582-8773		Educator LicensingYesED-02443-09
Application for Duplicate License
This form can be used to request a duplicate of your Minnesota Teaching License. It has been updated and can be completed on a computer; however, it must be printed and mailed to Educator Licensing with original signature and a $1.00 processing fee.
Nancy Farvour
651-582-8773		Educator LicensingNoED-02352-10
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
Dan Smith
651-582-8330		01643-14
Application for Special Education Funds - Statement of Assurances (FY 2014)
Michelle Jones
651-582-8577		School FinanceED-01350-30
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 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
Capital Expenditure Disabled Access Revenue Levy Authority Application
Chris Kubesh
651-582-8319		School FinanceED-02081-20
Charter School Transportation Survey 2013-14 School Year
2012-03-01Kelly Wosika
651-582-8855		School FinanceYesED-02425-07
Child and Adult Care Food Program (CACFP) Agreement
Food and Nutrition Service
651-582-8698		Child/Adult Care ProgramsNoED-02409-04E
Concurrent Enrollment Aid Application
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.
2013-03-15Sally Wherry
651-582-8768		Hg Sch/DualCred/Alt/OnlineLrngED-02456-02
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 2012 and FY 2013
Sarah Miller
651-5828370		School FinanceED-000110-36
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 Particpant 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
Early Graduation Achievement Scholarship and Military Service Award Programs Request for Payment
This form is to be completed by any Minnesota public school graduate who has received a ?Certificate of Eligibility? for either an Early Graduation Achievement Scholarship OR a Military Service Award from the Minnesota Department of Education.
Dual Enrollment Specialist
651-582-8852		Hg Sch/DualCred/Alt/OnlineLrngED-02464-02
Early Graduation Achievement Scholarship and/or Military Service Award Programs Application
Form to be completed by the student who is interested in applying for an Early Graduation Achievement Scholarship and/or a Military Service Award.
Dual Enrollment Specialist
651-582-8852		Hg Sch/DualCred/Alt/OnlineLrngED-02463-03
English Learner Parent Notification - State
Sample letter districts send to notify parents of student placement into an ESL or Bilingual Education program
Anh Tran
Student Support Federal ProgramsYes02246-02E
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 2012-13
For Charter Schools within their first three years of operation.
Jeanne Krile
651-582-8637		School FinanceYesED-02158-20
Enrollment Projections Report - School Year 2013-14
For Charter Schools within their first three years of operation.
Jeanne Krile
651-582-8637		School FinanceYesED-02158-21
Enrollment Projections Report - School Year 2014-15
For Charter Schools within their first three years of operation.
Jeanne Krile
651-582-8637		School FinanceYesED-02158-22
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
Milk Programs Application (New Sponsors) for FY2012
July 2011 - June 2012 paper application for new sponsors
2012-06-30Food and Nutrition Service
651-582-8698		Program Applications & USDA FoodsYesED-02123-18E
Monthly Transportation Reimbursement Request - Open Enrollment and Charter School Enrollment Programs
Kelly Wosika
651-582-8855		School FinanceED-01876-24
Monthly Transportation Reimbursement Request - Postsecondary Enrollment Options Program
Kelly Wosika
651-582-8855		School FinanceED-01765-27
Nonpublic Fall Report - 2012-13
Carol Hokenson
651-582-8840		School FinanceED-00027-37
Parent Committee Resolution Form
Form that may be used when writing a resolution to form an American Indian Parent Committee for the 2012-2013 school year.
2012-12-15Dennis Olson
651-582-8300		Equity & InnovationYes
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-01652-31
Q Comp Plan Change Form
This plan change form must be used by all implementing districts as a means of providing information to MDE regarding changes to a districts Q Comp program; deadlines for submitting Q Comp plan changes for the next school year are January 15 and April 15.

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 a Personnel Variance
This form has been updated and can now be completed on a computer, but MUST still be printed and signed before submitting.
Kat Anthony-Wigle
651-582-8415		Educator LicensingYesED-00330-24
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
Request for Permission to Hire a Non-licensed Community Expert
Form and guidelines for districts applying for a non-licensed individual to teach when a licensed teacher is not available (Minn. Stat. 122A.25). Please read the guidelines before completing the form.
Heather Ward
651-582-8213		Board of TeachingYesED-02396-01
School District Credit Enhancement Application for Program Participation
Sarah Miller
651-5828370		School FinanceED-02110-06
School Nutrition Programs (SNP) Application - FY2012
July 2011 - June 2012 paper application for new sponsors
2012-06-30Food and Nutrition Service
651-582-8698		School Nutrition ProgramsYesED-02123-18E
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 2012
Due February 1, 2013
Jan Carlson
651-582-8342		School FinanceED-02009-24
School Tax Abatement Six-Month Supplemental Report
Jan Carlson
651-582-8342		School FinanceED-02124-19
School Tax Report - 2012 Payable 2013
Jan Carlson
651-582-8342		School FinanceED-00119-36
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.
Marlys Bucher
651-582-8315		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) 2012-2013
(ED-02432)
George Holt
651-582-8889		School FinanceED-02432-07
Special Education Application Out-of-State Tuition for Minnesota Residents 2012-2013
(ED-02431)
George Holt
651-582-8889		School FinanceED-02431-07
Special Education Application Special Pupils With Individual Education Programs (IEPs) 2012-2013
(ED-02433)
George Holt
651-582-8889		School FinanceED-02433-07
Special Education Application Special Pupils Without Individual Education Programs (IEPs) 2012-2013
(ED-02434)
George Holt
651-582-8889		School FinanceED-02434-07
Special Expenditure Worksheet II-C Individual Student Placements
Michelle Jones
651-582-8577		School Finance
Statewide Enrollment Options
Enrollment Options/Open Enrollment Form
2013-01-15Cindy 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 - 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
Supplemental Notice of Student Enrollment 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/OnlineLrng
Taconite Credit Report
Jan Carlson
651-582-8342		School FinanceED-02331-10
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 - 2012-2013 School Year
Jeanne Krile
651-582-8637		School FinanceED-02424-07
 
 
 
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  • Minnesota Department of Education