Get Authorized Program Contact Apc Access Brequest Formb

The Authorized Program Contact Access Request Form is essential for individuals who require access to the Gateways Registry Director Portal and/or the ExceleRate Illinois Program Portal. This guide will assist you in filling out the form online with clarity and ease.

Follow the steps to complete the form efficiently.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In the 'Primary Authorized Program Contact' section, provide your full name and Registry Member ID. If you do not have a Registry Member ID, ensure to indicate any alternative identifier as instructed.
3. Fill in the 'Program/Site Name', 'Address', 'City', 'Zip Code', and 'Phone' fields accurately to ensure correct identification and communication.
4. If applicable, enter your IDCFS License Number and ISBE Preschool for All Grantee ID. Ensure these details are correct to facilitate seamless processing.
5. Indicate the portal(s) for which you are requesting access by checking the corresponding box for either the Gateways Registry Director Portal or the ExceleRate Illinois Program Portal.
6. For additional authorized program contacts, fill out the 'Name' and 'Registry Member ID' fields and check the appropriate boxes for the portals they should have access to.
7. Review the agreement statement confirming your role as the primary administrative contact and sign the document in the designated space.
8. Enter the date of signature to complete this section of the form.
9. Once filled out, proceed to save your changes. You can choose to download, print, or share the completed form based on your requirements.

Complete your document online today for efficient access to necessary resources.