Keys for K-12 Instructor Application

Thank you for your interest in the Keys for K-12 program.

Please fill out this online form in order to create your Keys for K-12 instructor account. Note that only one instructor per school will be eligible to receive this free license. Also note that you must be the instructor or administrative contact for at least one student who has been submitted for enrollment in the KK-12 program. You will need the user name or account number referenced on the student's application in order to complete this form.

Upon submitting this online form, you will receive a a link to a PDF which must be printed, signed, and returned to Serotek within 60 days.

Instructor's first name
Instructor's last name
Instructor's position
Name of school
School address
Address (line 2, if any)
City
State
zip code
Instructor's preferred contact phone number
The email address you enter below will be used for all future Serotek communications.
Instructor's email address
In the field below, enter the user name you want to use for Sero email.
Instructor's desired user name
Please enter your student's user name or account number, which was provided during the KK-12 signup process for your student.
Student's user name or account number