Cal-PASS Plus - NewMou

Welcome to Cal-PASS Plus!
To join, please complete and submit the MOU REQUEST FORM below. When your request is received, you will receive an email containing the full MOU for review and signature. You must sign and return the full MOU to the following address to join: Cal-PASS Plus, 2300 N Street, Suite 3, Sacramento, CA 95816. If you have questions, please contact our office at 916-498-8980.

MOU Information

Said letter shall be executed by an authorized officer of the institution.

Organization Name:

Mou Date:

Now

MOU Manager / Primary Contact

MOU Manager/Primary Contact: This person is responsible for coordinating the Cal-PASS Plus process at your institution and is authorized to change data access features such as the data sharing partners list and opting in or out of larger research studies on behalf of the institution. This is also the person who will receive a primary User ID and Password, which are required to access data and performance reports on the web site. This person will also be the primary contact to identify, approve and add or modify other authorized users at your institution.

First Name:

Last Name:

Title:

Phone Number:

Email Address:

Authorized Officer

First Name:

Last Name:

Title:

Email Address:

Phone Number:

Data Submission Contact

Information Technology Contact: This person is responsible for generating and submitting the data files.

First name:

Last Name:

Title:

Phone Number:

Email Address:

MOU Submission Instructions After completing this MOU request form you will receive the full MOU via email. Please sign and return to the address below.

Ken Sorey Cal-PASS Plus Project Director
2300 N Street, Suite 3
Sacramento, CA 95816