GCSA GaTAPP 2012-2013 Cohort Registration

1. GCSA GaTAPP Program Registration 2012-2013

Thank you for registering for the Georgia Teacher Academy for Preparation and Pedagogy (GaTAPP) offered through The Georgia Charter Schools Association.

The program listed below are facilitated by GCSA staff. Course descriptions, training formats, course completion requirements, and costs can be found in the Professional Development Course catalog found on the GCSA website at www.gacharters.org (Services tab - CharterUniversity).

*Registering for the GaTAPP program does not confirm your enrollment in the program. This will happen via a formal review process and upon completion of the application packet and transcript review.

Payment for the program is due prior to participation in the program. If you wish to pay in installments, please contact the GaTAPP Program Director at jsergi@gacharters.org.

Thank you again for your interest.

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* 1. Please complete your contact information.

First and Last Name: *

School Name:

School Address: *

City/Town: *

State: *

ZIP: *

School Email Address:

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* 2. Please complete your contact information.

Personal Address:

City/Town:

State:

ZIP:

Personal Email Address:

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* 3. I am a GCSA member.

Yes

Unsure

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* 4. Please select the role(s) that you currently serve.

Leader/Principal/Director

Leadership Team Member

Regular Education Teacher

Special Education Teacher

Gifted Education Teacher

ESOL Teacher

Other (please specify)

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* 5. Professional development course(s) for which you are registering:

GaTAPP

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* 6. Please describe how you will be paying for your professional development. Costs for professional development courses can be found in the Course Catalog on GCSA's website. The GaTAPP Program fee is $4000.00 ($4500 for non-member schools) which includes the $85.00 application fee for processing and the $115.00 LiveText.

Bill my school

Credit Card

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* 7. A form of payment must be entered to hold your seat in this program. If Bill School is selected, please have your administrator contact the GaTAPP Program Director via email at jsergi@gacharters.org to confirm this and we will directly invoice the school.Please provide credit card information below to hold your seat and cover your first payment of $115.00 for a LiveText account and the $85.00 application to be processed=$200:

Type of Card

Name on the Card

Card Number

Expiration Date

CVC Number

Billing Address

Amount Authorized to Charge $200.00

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* 8. Do you currently hold a valid non-renewable certificate?

Yes

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* 9. If yes, what certificate do you hold and in what fields (include field numbers)?

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* 10. If you hold a non-renewable Certificate, what is the certificate ID #? If you do not, please leave blank.

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* 11. Have you passed or exempted all sections of the GACE Basic Skills?

Yes

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* 12. Have you passed the GACE in the content area you are seeking certification?

Yes

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* 13. What GACE tests have you passed, including field numbers?

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* 14. What grade levels are you seeking certification?

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* 15. What content area are you seeking certification?

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* 16. What content area are you currently teaching?

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* 17. What grade level(s)are you currently teaching?

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* 18. Have you passed the GACE Pedagogy?

Yes

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* 19. Please provide a brief statement about your teaching and learning philosophy.

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* 20. Do you hold a Bachelor's degree and if yes, from what institution and in what area? Do you hold any other higher degrees, and if yes, from what institution and in what areas? (i.e., Ohio University MED Secondary Education in Biology)

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* 1. Please complete your contact information.

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* 2. Please complete your contact information.

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* 3. I am a GCSA member.

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* 4. Please select the role(s) that you currently serve.

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* 5. Professional development course(s) for which you are registering:

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* 8. Do you currently hold a valid non-renewable certificate?

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* 9. If yes, what certificate do you hold and in what fields (include field numbers)?

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* 10. If you hold a non-renewable Certificate, what is the certificate ID #? If you do not, please leave blank.

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* 11. Have you passed or exempted all sections of the GACE Basic Skills?

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* 12. Have you passed the GACE in the content area you are seeking certification?

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* 13. What GACE tests have you passed, including field numbers?

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* 14. What grade levels are you seeking certification?

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* 15. What content area are you seeking certification?

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* 16. What content area are you currently teaching?

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* 17. What grade level(s)are you currently teaching?

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* 18. Have you passed the GACE Pedagogy?

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* 19. Please provide a brief statement about your teaching and learning philosophy.

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* 20. Do you hold a Bachelor's degree and if yes, from what institution and in what area? Do you hold any other higher degrees, and if yes, from what institution and in what areas? (i.e., Ohio University MED Secondary Education in Biology)

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* 21. Do you have any immediate questions about the program, payment plan, process, etc. that I can email you a response to at this time?