Private Post Secondary Degree Granting Application
Chapter 30 Application
Payment Received
Yes
No
Payment Method
Check Number or ACH Date
Amount Paid
Institution Information
Name of Institution
*
Date
-
Month
-
Day
Year
Date
Is the institution accredited through an accrediting body approved by the US Department of Education?
*
Yes
No
Name of accrediting association
Registration Period (July 1 through June 30 annually)
*
Please Select
2025-2026
2026-2027
Contact Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Physical Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mailing Address (if different)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Website/URL
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Local Information
Does the institution have any physical presence in Wyoming?
*
Yes
No
Local Director
First Name
Last Name
Local Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Local Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Local Director Email
example@example.com
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Registered Agent
An agent is defined as anyone who represents the institution who solicits students in the State of Wyoming. This includes events such as career fairs or school visits.
Does the institution wish to license an agent?
*
Yes
No
By accepting the terms, the institution verifies that it has carefully reviewed the qualifications and the personal data of the agent and believes that he/she will perform as pledged above.
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Payment Information
A $100 fee is required for each application. Additionally, please submit $100 for each registered agent. Checks should be sent to: Wyoming Department of Education Attn: Brenna 122 W. 25th St. Suite E200 Cheyenne, WY 82002
Number of agents being registered today
*
Cost of agent registrations
Base Application Fee
Total Amount Due
Method of Payment
*
Check
ACH Transfer
Credit Card
Check Number
Date of ACH Transfer
-
Month
-
Day
Year
Date
Credit Card Processing
Signature
*
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Submit
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