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.