MA ADMIN SEI Endorsement Registration Form 
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Date *
MM
/
DD
/
YYYY
Email *
Phone *
Full Legal Name *
Course *
Required
MEPID *
Date of Birth (Month and Day) *
District Code
Found at http://profiles.doe.mass.edu) 
 *
District Name
Found at http://profiles.doe.mass.edu) 
 *
Subject Taught/Grade Level *
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