I hereby agree that I am authorized by the institution listed on this form to submit requests for
Designated Institution (DI) codes and/or changes to existing DI listings, and to act on behalf of such
institution. To the best of my knowledge, the information I have provided is accurate, current and
complete. I understand that ETS is not liable for the accuracy or completeness of the information
collected or displayed. I also understand that I will be contacted by ETS as part of the verification/sign
up process. Further, by applying to become a DI I hereby consent to all terms and conditions of the
policies listed on
www.ets.org for myself and on behalf of the institution.
I herby consent to ETS creating an ETS Data Manager account upon the creation of the Designate Institution
(DI) code.