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DPI Confidential Data Application

Enter the information below to submit an application for confidential data to the Wisconsin Department of Public Instruction (DPI).  This application is designed to assist in reviewing confidential data requests for purpose, scope, and compliance with data privacy and confidentiality required by federal and state law.  Please fill out the application as thoroughly as you can so DPI can effectively evaluate the application submittal and determine the action to pursue.  If the application is approved by DPI, the application information will be used to create a Data Use Agreement between DPI and the Requestor.

Each individual and/or organization must agree to the following confidential data responsibilities.

  • Agree to and execute a Data Use Agreement (DUA) if the application is approved
  • Provide and maintain accurate and complete responses on the application and promptly notify DPI of any change(s)
  • Maintain up to date data recipient(s) information with DPI and, if necessary, reflect any transition within fifteen (15) days
  • When a change is required to an existing DUA, promptly submit to DPI the appropriate information for renewal, modification or extension
  • Safeguard the integrity of the data received and comply with all applicable federal and state laws for protecting its privacy and security
  • Ensure that DPI breach notification and response procedures are followed in the event of potential or actual loss, theft, or compromise of data as outlined on the DUA
  • Adhere to DPI Pupil Data Policy requirements, if applicable
  • Destroy all personally identifiable data connected to the DUA and submit the DPI Data Destruction Certificate to DPI as outlined in the DUA expiry process or when the data are no longer necessary, whichever comes first

Requests are reviewed monthly by an internal team

NOTE !  Do not submit any Sensitive Personally Identifiable Information (SPII) through this form.  Click for a list of SPII examples.

Contact and organization information for the confidential data application.
Any phone number format will do, but include your area code like: 920-555-1212
Enter the name of the organization for the purpose of this application.
Enter the organization's address, city, state, zip code, and phone number.
Organization Type
Select the type of organization the confidential data will be delivered to.
General Information
To help us determine and prioritize future public data offerings, tell us why public data (i.e. WISEdash Public Portal and downloadable spreadsheets) available on the DPI website cannot be used for this request.
Enter the DPI contact name if you have been in contact or currently working with someone at DPI on this request.
Research Information
Do you have IRB approval?
Is the research approved by an Institutional Review Board (IRB) for purposes of human subjects study? After your application is submitted, DPI will be contacting you for supporting documentation to support your answer.
Desired Research Start Date
Projected Research End Date
Describe the scope of the entire project in clear and non-technical language. Limit response to 250 words.
Write the primary research questions as clearly and precisely as possible.
How will your research benefit education in the state of Wisconsin?
List all the expected products from this research project. (i.e. journal article, book chapter, web tool, white paper, other output. . .)
Information about the requested data
Describe the confidential data you are requesting in this application. Do not enter any Sensitive Personally Identifiable Information (SPII) in this section.
Level of detail or summarization needed for the data requested
State
District
LEA (Local Education Agency)
School
Teacher/Class
Student
Select the data level of detail needed to support this request. (multiple selections are allowed)
Data Delivery Date
Enter the date the requested data should be delivered to you for your effort.

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