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The Georgia PSC Employer Assurance Form serves a vital role in the certification process for educators in the state of Georgia. This essential document is designed to confirm the employment status of individuals seeking certification as educators, ensuring that they meet the necessary qualifications and standards set forth by the Georgia Professional Standards Commission (GaPSC). It is imperative for public school employers to submit this form electronically through their account on the GaPSC website, while other employers in Georgia may facilitate the process by allowing applicants to upload the form via MyPSC. The form requires detailed information about the applicant, including their name, date of birth, and GaPSC certification ID number. Additionally, employers must verify that all requisite background checks have been conducted and that any ethical violations have been reported. The form also allows employers to request various transactions on behalf of the applicant, such as the issuance of a new certificate or the renewal of an existing one. Completing this form accurately is crucial, as it not only verifies employment but may also exempt applicants from certain certification fees. With specific sections dedicated to employment verification, transaction requests, and employer information, this form is a comprehensive tool that streamlines the certification process for educators across the state.

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Georgia PSC Employer Assurance Form – Revised June 2021

DO NOT MAIL!

Public School Employer: Must submit electronic form through www.gapsc.org account

All other GA Employers may complete the form for applicant to upload via MyPSC

This form is to be used to verify current employment as a Georgia educator.

1. Applicant Information

 

 

 

 

 

 

 

Please use dark ink.

 

Title

 

 

Last Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mr. Ms.

Dr.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

First Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Middle Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GaPSC Certification ID Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of Birth (MM/DD/YY)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Sections 2, 3, & 4 must be completed by the employer.

2. Employment Verification:

In submitting this form, I certify that all required background checks have been completed for this applicant and any violations of the Georgia Code of Ethics for Educators have been reported to the GaPSC. I also certify that the applicant is/will be working within the local unit of administration (LUA) I represent in a position requiring GaPSC certification and that the applicant is/will be employed by the LUA or by an outside agency contracted by the LUA to provide staffing or educational services.

Employment is in the certification field of :

Employment in this certificate field began on:

/

(MM/DD/YY)

/

3. Transaction Request:

I am requesting the following transaction(s) on behalf of the applicant listed above (check all that apply):

First GA certificate (applicant holds professional out-of- state certificate)

Renewal- A PLP/PLG has been established and the educator is making adequate progress toward meeting the plan/goals?

Yes No Addition of a new field

Conversion or Extension

Upgrade

Montessori certificate Educational Interpreter

Non-Renewable type certificate and field:

 

Field Code:

 

 

(see reverse)

Non-Renewable Types: Induction, International Exchange, Military Support, Permit, Provisional, or Waiver

Other unlisted transaction (please specify):

4. Employer Information:

Name of Superintendent or authorized designee (print/type)

 

Signature (eSignature not accepted)

 

 

 

 

 

 

 

Title

 

 

Date

 

 

 

 

 

Phone Number

Email Address

 

Name of Local Unit of Administration (School System / Agency / Private School / Institution)

Initial if applicable: __________ This is a virtual school based outside of Georgia. I certify that the applicant listed above will be working with Georgia students.

EMPLOYER ASSURANCE FORM INSTRUCTIONS – Revised June 2021

Note: Please complete all forms legibly in black ink or type.

The Georgia PSC Employer Assurance Form should accompany all applications for certification when the applicant is employed or will be employed by a Georgia public or private school system/agency. When possible, this form should be submitted electronically through the employer’s account on

www.gapsc.org. This form is used for the following:

To verify that the applicant is currently employed or will be employed in the listed system/agency and all required background checks have been completed;

To exempt the applicant from the certification fee in some cases; and

To request a Permit, International Exchange, Waiver, or non-renewable type certificate.

CERTIFICATE FIELD CODES

TEACHING FIELDS

Elementary Fields

Birth Through Kindergarten 870

Elementary Education (P-5) 808

SpEd Gen Curriculum/Elementary Education (P-5)

708

Middle Grades (4-8):

Language Arts - 853

Mathematics - 851

Reading - 855

Science - 852

Social Science - 854

Secondary Fields (6-12)

Agriculture788

Behavioral Science 766

Biology 750

Business 783

Chemistry 752

Earth/Space Science 753

Economics 757

Engineering and Technology 769

English 730

Family/Consumer Science 790

Geography 759

Healthcare Science 619

History 755

JROTC: Air Force 643

JROTC: Army 641

JROTC: Marine Corps 644

JROTC: Navy 642

Marketing 792

Mathematics 743

Physics 751

Political Science 756

Science (Broad Field) 748

Speech 733

Trade & Industrial Education:

Architectural Drawing and Design 658

Audio/Video Technology & Film 652

Automotive Service Tech 650

Aviation 830

Barbering 613

Collision Repair 653

Computer Animation 678

Construction - 656

Cosmetology 525

Culinary Arts - 669

Distribution & Logistics654

Electronics Technology 657

Esthetics 614

Government & Public Administration680

Granite Technology 659

Graphic Communications & Design 660

IT/Info Services & Support 662

IT/Network Systems - 663

IT/Programming & Software Dev. 664

IT/Cybersecurity 676

Manufacturing & Engineering Sciences 667

Marine Service Technology 618

Nails 615

Precision Machine Technology 668

Law, Public Safety, Corrections & Security 670

Sheet Metal 671

Welding Technology 673

Foreign Languages (P-12)

American Sign Lang.

832

Arabic

845

Chinese (Mandarin)

834

Farsi

848

French

836

German

838

Greek (Classical)

842

Hebrew

841

Hindi

843

Italian

840

Japanese

831

Korean

846

Latin

835

Portuguese

844

Russian

839

Spanish

837

Swahili

847

Turkish

850

Urdu

849

Special Education (P-12) Consultative Sp Ed Adapted Curriculum 805 Behavior Disorders 778

Deaf Education 797

Sp Ed General Curriculum 798

SpEd General Curriculum/Elementary Education (P-5 only) 708

Learning Disabilities 777 Physical & Health Disabilities 768 Sp Ed Preschool (ages 3-5) 799 Visual Impairment 722

Sp Ed Academic Content Concentrations:

 

P-5

4-8

6-12

Language Arts

930

931

932

Mathematics

910

911

912

Reading

950

951

952

Science

920

921

922

Social Science

940

941

942

P-12 Fields

Art 764

Computer Science 789

Dance 820

Drama 821

Eng. To Speakers of Other Lang. (ESOL) 885

Gifted (P-12) Consultative 780

Gifted Concentrations:

Language Arts 963

Mathematics 961

Reading 965

Science 962

Social Science 964

Health Education - 760

Health and Physical Education 761

Music 767

Reading 732

SERVICE FIELDS (P-12)

Audiology 801

Media Specialist 813

School Counseling - 709

School Nutrition Director 729

School Psychology711

School Social Work 715

Speech and Language Pathology 802

Curriculum & Instruction 902

Instructional Technology 903

Teacher Leadership 904

LEADERSHIP FIELDS (P-12)

Educational Leadership-Tier I --700

Educational Leadership- Tier II -- 710

ENDORSEMENTS

Teaching Endorsements: Agriculture Education (P-5) 892 Autism 877

Birth Through Five 871

Career Exploration (PECE) 749 Career Technical Instruction (CTI) 810 Coaching Endorsement 980 Computer Science 882

Coordinated Career Academic Ed (CCAE) -770 Culinary Arts 884

Dramatic Writing Micro-Endorsement 350 Dual Immersion Elementary Education 863 ESOL 825

Gifted In-Field 881 Intervention Specialist 887 K-5 Mathematics 970 K-5 Science 971 Middle Grades859 On-Line Teaching 898 Personalized Learning 889

Positive Behavior Intervention and Supports (PBIS) 189

Reading 833

Safety & Driver Education 763 Sp Ed Deaf Education 874

Sp Ed Physical & Health Disabilities 875 Sp Ed Preschool (ages 3-5) 826

Sp Ed Transition Specialist 873

Sp Ed Visual Impairment 876 STEM Education 186 Urban Education 891 Work-Based Learning 793

Service Endorsements:

Student Support Team Coordinator 888 Teacher Support and Coaching 712

Leadership Endorsements:

Teacher Leader 774

Form Specifications

Fact Name Fact Description
Form Purpose This form verifies current employment for Georgia educators.
Submission Method Public school employers must submit electronically via www.gapsc.org.
Employer Requirement Sections 2, 3, and 4 need to be completed by the employer.
Background Checks Employers must certify that all required background checks are completed.
Certification Field Employment must be in a position requiring GaPSC certification.
Certification Fee The form may exempt applicants from certification fees in certain cases.
Governing Laws This form is governed by the Georgia Code of Ethics for Educators.
Legibility Requirement All forms must be completed legibly in black ink or typed.

Georgia Psc Employer Assurance: Usage Guidelines

After completing the Georgia PSC Employer Assurance form, the employer must ensure the form is submitted electronically through the appropriate channels. This is essential for verifying the applicant's employment status and ensuring compliance with certification requirements.

  1. Access the Georgia PSC Employer Assurance form online.
  2. Fill in the applicant's information in Section 1:
    • Use dark ink or type.
    • Provide the title (Mr., Ms., Dr.), last name, first name, middle name, GaPSC certification ID number, and date of birth in the specified format (MM/DD/YY).
  3. Complete Sections 2, 3, and 4, which must be filled out by the employer:
    • In Section 2, verify employment and certify background checks have been completed.
    • Indicate the certification field and the start date of employment.
  4. In Section 3, check all applicable transaction requests for the applicant.
  5. In Section 4, provide employer information:
    • Print or type the name of the superintendent or authorized designee.
    • Sign the form (eSignature is not accepted).
    • Include the title, date, phone number, and email address.
    • State the name of the Local Unit of Administration (school system, agency, private school, or institution).
    • If applicable, initial the section indicating the virtual school based outside of Georgia.
  6. Review the completed form for accuracy and completeness.
  7. Submit the form electronically through the appropriate platform as instructed.

Your Questions, Answered

What is the purpose of the Georgia PSC Employer Assurance Form?

The Georgia PSC Employer Assurance Form is designed to verify the current employment status of individuals applying for educator certification in Georgia. It ensures that all necessary background checks have been completed and that any violations of the Georgia Code of Ethics for Educators have been reported. This form is essential for applicants who are employed or will be employed by a Georgia public or private school system or agency.

Who needs to submit the form?

Public school employers in Georgia must submit the form electronically through their account on www.gapsc.org. Other employers in Georgia, such as private schools or agencies, may complete the form for the applicant to upload via MyPSC. It is important for all employers to ensure that the form is filled out accurately and submitted in a timely manner to facilitate the certification process.

What information is required from the applicant?

Applicants must provide their personal information, including their title, last name, first name, middle name, GaPSC Certification ID number, and date of birth. This information is crucial for the identification and processing of their application. All details should be completed using dark ink for clarity.

What does the employer need to certify on the form?

The employer must certify that all required background checks for the applicant have been completed and that any violations of the Georgia Code of Ethics for Educators have been reported. Additionally, the employer must confirm that the applicant is or will be working in a position that requires GaPSC certification within their local unit of administration (LUA).

Can the form be submitted in paper format?

No, the form should not be mailed. It must be submitted electronically through the appropriate channels. Public school employers should use their account on www.gapsc.org, while other employers should ensure the applicant uploads the completed form via MyPSC.

What types of transactions can be requested through this form?

The form allows employers to request various transactions on behalf of the applicant. These include the issuance of the first Georgia certificate, renewal of certification, addition of a new field, conversion or extension of certification, and upgrades. Employers can also request specific types of non-renewable certificates or other unlisted transactions as needed.

What should employers do if the applicant is working for a virtual school outside of Georgia?

If the applicant is working for a virtual school based outside of Georgia, the employer must initial the designated section on the form. This indicates that the applicant will be working with Georgia students, which is essential for compliance with state regulations regarding educator certification.

Common mistakes

  1. Using the wrong ink color: The form must be completed in dark ink, preferably black. Using any other color can lead to processing delays.

  2. Incomplete applicant information: Ensure all fields in the applicant information section are filled out completely, including the GaPSC Certification ID Number and Date of Birth.

  3. Employer sections left blank: Sections 2, 3, and 4 must be completed by the employer. Omitting any of these sections can result in the form being rejected.

  4. Incorrect employment verification: Employers must certify that all required background checks have been completed and any violations reported. Failing to do so can lead to serious consequences.

  5. Missing or incorrect transaction requests: When requesting transactions, ensure all applicable boxes are checked. Omitting this information can delay the application process.

  6. Signature issues: The form must include a handwritten signature from the Superintendent or authorized designee. eSignatures are not accepted.

  7. Incorrect employer information: Provide accurate details about the local unit of administration. Double-check the name and contact information to avoid errors.

  8. Failure to initial for virtual schools: If applicable, the employer must initial the section indicating the school is virtual and located outside of Georgia.

  9. Not submitting electronically: Georgia public school employers must submit the form electronically through their GaPSC account. Failing to follow this instruction can lead to processing delays.

Documents used along the form

The Georgia PSC Employer Assurance Form is an essential document for verifying the employment status of educators in Georgia. However, several other forms and documents often accompany this form to ensure a smooth certification process. Below is a list of these important documents, each serving a specific purpose in the certification journey.

  • GaPSC Certification Application: This application is the primary document submitted by individuals seeking certification. It collects personal information, educational background, and details about the certification sought.
  • Background Check Consent Form: This form authorizes the Georgia Professional Standards Commission to conduct background checks on the applicant. It ensures that all necessary safety and ethical standards are met.
  • Verification of Employment Form: Similar to the Employer Assurance Form, this document confirms an applicant's employment history and qualifications. It is often required when applying for certification or renewal.
  • Transcripts and Educational Records: Official transcripts from colleges or universities are needed to verify that the applicant has completed the necessary educational requirements for certification.
  • Professional Learning Plan (PLP): For those seeking renewal of their certification, this plan outlines the professional development activities the educator has undertaken to meet ongoing education requirements.
  • Code of Ethics Acknowledgment: This form confirms that the applicant understands and agrees to adhere to the Georgia Code of Ethics for Educators, which is crucial for maintaining the integrity of the teaching profession.

Understanding these documents and their purposes can significantly streamline the certification process for educators in Georgia. Each form plays a vital role in ensuring that applicants meet the necessary requirements and maintain the standards expected in the education field.

Similar forms

  • Employment Verification Letter: Similar to the Georgia PSC Employer Assurance form, this document confirms an individual's current employment status and verifies their job title, responsibilities, and duration of employment. It is often used for loan applications or background checks.
  • Certificate of Good Standing: This document is issued by a regulatory body to confirm that an individual or organization is compliant with all applicable laws and regulations. Like the Employer Assurance form, it provides assurance of ethical conduct and adherence to standards.
  • Background Check Consent Form: This form is used to obtain permission from an individual to conduct a background check. It is similar in purpose to the Employer Assurance form, as both require verification of background checks for employment purposes.
  • Professional Reference Form: This document collects feedback about an applicant’s work history and qualifications from previous employers or colleagues. Both forms serve to validate an applicant’s professional background and suitability for a position.
  • Job Offer Letter: This letter formally offers employment to a candidate and outlines the terms of employment. Like the Employer Assurance form, it is essential for confirming an applicant's employment status and role within an organization.
  • Application for Certification: This form is used by educators to apply for certification, similar to how the Employer Assurance form is utilized to verify employment for certification purposes. Both documents are integral to the certification process.
  • Verification of Employment (VOE) Form: This document is often requested by lenders to confirm an applicant’s employment and income. It serves a similar function to the Employer Assurance form in verifying employment status.
  • Contract for Employment: This legal document outlines the terms of employment between an employer and employee. Like the Employer Assurance form, it confirms the employment relationship and responsibilities of the parties involved.
  • Educational Credential Verification Form: This form verifies an individual's educational qualifications and is often required for employment or certification. It shares the same goal of ensuring that the applicant meets the necessary standards for their profession.

Dos and Don'ts

When filling out the Georgia PSC Employer Assurance form, there are important dos and don'ts to keep in mind. Following these guidelines can help ensure that your submission is accurate and complete.

  • Do use dark ink or type the information to ensure legibility.
  • Do complete all sections of the form, especially those that require employer input.
  • Do submit the form electronically through your account at www.gapsc.org if you are a public school employer.
  • Do verify that all required background checks for the applicant have been completed.
  • Don't mail the form; it must be submitted electronically.
  • Don't leave any sections blank; incomplete forms may delay processing.
  • Don't forget to sign the form; an eSignature is not accepted.

Misconceptions

Understanding the Georgia PSC Employer Assurance Form is crucial for both employers and applicants. However, several misconceptions can lead to confusion. Here are five common misconceptions:

  • Only public schools need to submit the form. This is incorrect. While public school employers must submit the form electronically, all other Georgia employers can also complete it for the applicant to upload via MyPSC.
  • The form can be mailed to the Georgia PSC. This is a misunderstanding. The instructions clearly state that the form should not be mailed and must be submitted electronically through the appropriate channels.
  • All sections of the form must be filled out by the applicant. This is misleading. Sections 2, 3, and 4 are specifically designated for completion by the employer, not the applicant.
  • The form is only for verifying current employment. While employment verification is a primary purpose, the form also serves to request various transactions related to certification, such as permits or renewals.
  • Electronic submission is optional for all employers. This is not true. Public school employers are required to submit the form electronically through their www.gapsc.org account, making it a necessary step in the process.

Clarifying these misconceptions can help streamline the certification process for educators in Georgia.

Key takeaways

When filling out the Georgia PSC Employer Assurance Form, keep these key takeaways in mind:

  • Electronic Submission: Public school employers must submit the form electronically via their account at www.gapsc.org. Other employers can complete the form for applicants to upload through MyPSC.
  • Legibility Matters: Ensure all sections are completed clearly using dark ink or by typing. This helps avoid delays in processing.
  • Verify Employment: The form is primarily used to confirm that the applicant is currently employed or will be employed as a Georgia educator, with all required background checks completed.
  • Transaction Requests: Employers can request various transactions on behalf of the applicant, such as certification renewals or new field additions. Be sure to check all that apply.
  • Signature Requirement: The form must be signed by the superintendent or an authorized designee. Remember, electronic signatures are not accepted.