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Enter Registrant ID
Apostroph is not allowed in Registrant ID
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Your registrant ID can be numbers or letters up to 10 characters in length.
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Enter Password
Password can contain letters, numbers and the following symbols: !@#$()
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Must be at least 8 characters.
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Enter confirm PasswordPassword don't match
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Must be at least 8 characters.
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Enter First Name
Numbers not allowed in First Name
Text 'First Name' not allowed
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Title Case, please
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Numbers not allowed in Middle Name
Text 'Middle Name' not allowed
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Optional
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Enter Last Name
Numbers not allowed in Last Name
Text 'Last Name' not allowed
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Title Case, please
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Are you required to obtain SCECHs to renew your Michigan Department
of Education issued certificate or license (professional education teaching certificate,
occupational education certificate, school guidance counselor license, school psychologist
certificate, school administrator certificate/continued employment)?
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*REQUIRED*
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Enter Work Phone area code
InvalidWork Phone area code
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Enter Work Phone prefix
InvalidWork Phone prefix
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Enter Work Phone suffix
InvalidWork Phone suffix
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Invalid Value in Work Phone Extension
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Optional
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InvalidHome Phone area code
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InvalidHome Phone prefix
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InvalidHome Phone suffix
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Invalid Value in Home Phone Extension
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Optional
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InvalidFax area code
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InvalidFax prefix
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InvalidFax suffix
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Invalid Value in Fax Extension
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Enter Email Preference
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Required
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Enter Address1
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*REQUIRED*
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Optional
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Enter City
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*REQUIRED*
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Please select State
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*REQUIRED*
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Enter Zip
Zip is not valid.
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*REQUIRED*
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Primary Email should be in proper format.
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Necessary for e-mail reminders and confirmation.
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Confirm Primary Email should be in proper format.
Re-enter Primary Email
The Primary Email and Confirm Primary Email fields must match.
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Necessary for e-mail reminders and confirmation.
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Please select District
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If no district, choose "Agency" from drop down & add agency/district
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Optional
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Select your county
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Optional
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*REQUIRED*
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*REQUIRED*
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Optional
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Optional
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Optional
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Optional
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