GCSA Financial Certification Course Registration Cohort 3 Question Title * 1. Name First Name Last Name Question Title * 2. Social Security Number Question Title * 3. Date of Birth Date Date Question Title * 4. Home Address Home Address City State Zip Question Title * 5. Cell Phone Question Title * 6. Is your school authorized by the State Charter Schools Commission (SCSC)? If so, you may be eligible for a scholarship. Additional information will be provided upon confirmation of your charter authorizer. Please note: If you are authorized by Atlanta Public Schools, Fulton County Schools, DeKalb County School District, or any other public school district, you should answer "no" to this question. Yes No Question Title * 7. School Name (Employer) Question Title * 8. Title Question Title * 9. Work Email Address Question Title * 10. Candidate Status New Certification First Course New Certification Subsequent Course Renewal Certification Other (please specify) Question Title * 11. Comfort Level & Years of ExperienceFor each course topic, please rate your comfort level on a scale of 1-10 (10 = expert level and 1 = beginner level) and choose your years of experience from the drop-down list provided. Years of Experience Comfort Level Charter School Finance & Accounting No experience 1-2 years 3-5 years More than 5 years More than 10 years Charter School Finance & Accounting Years of Experience menu 1 2 3 4 5 6 7 8 9 10 Charter School Finance & Accounting Comfort Level menu Governmental Accounting 101 No experience 1-2 years 3-5 years More than 5 years More than 10 years Governmental Accounting 101 Years of Experience menu 1 2 3 4 5 6 7 8 9 10 Governmental Accounting 101 Comfort Level menu Charter School Budgeting No experience 1-2 years 3-5 years More than 5 years More than 10 years Charter School Budgeting Years of Experience menu 1 2 3 4 5 6 7 8 9 10 Charter School Budgeting Comfort Level menu Quality Basic Education (QBE) Formula No experience 1-2 years 3-5 years More than 5 years More than 10 years Quality Basic Education (QBE) Formula Years of Experience menu 1 2 3 4 5 6 7 8 9 10 Quality Basic Education (QBE) Formula Comfort Level menu Charter School Policy Development No experience 1-2 years 3-5 years More than 5 years More than 10 years Charter School Policy Development Years of Experience menu 1 2 3 4 5 6 7 8 9 10 Charter School Policy Development Comfort Level menu Procurement Policies & Practices No experience 1-2 years 3-5 years More than 5 years More than 10 years Procurement Policies & Practices Years of Experience menu 1 2 3 4 5 6 7 8 9 10 Procurement Policies & Practices Comfort Level menu Payroll & Compensation Practices No experience 1-2 years 3-5 years More than 5 years More than 10 years Payroll & Compensation Practices Years of Experience menu 1 2 3 4 5 6 7 8 9 10 Payroll & Compensation Practices Comfort Level menu Establishing Effective Internal Controls & Financial Oversight No experience 1-2 years 3-5 years More than 5 years More than 10 years Establishing Effective Internal Controls & Financial Oversight Years of Experience menu 1 2 3 4 5 6 7 8 9 10 Establishing Effective Internal Controls & Financial Oversight Comfort Level menu Audit Preparation No experience 1-2 years 3-5 years More than 5 years More than 10 years Audit Preparation Years of Experience menu 1 2 3 4 5 6 7 8 9 10 Audit Preparation Comfort Level menu Question Title * 12. Which course(s) are you registering for? Governmental Accounting 101: January 27, 2021 Policy Development, Implementation & Evaluation: January 28, 2021 QBE Funding & School Budget Development: February 24, 2021 Payroll, Compensation & Procurement Policies & Practices: February 25, 2021 Internal Controls & Effective Financial Oversight: March 31, 2021 Audit Preparation Best Practices: April 1, 2021 Question Title * 13. How will you pay for the training? Bill my school. Bill me directly. Question Title * 14. Payment Information - Note: Each individual course costs $300 per person. Schools must pay for each individual course before attending. GCSA will bill your school in advance of the course. Participants must complete all 6 courses to receive certification. The full six-course Financial Certification Program costs $1,800. Schools paying for the full six-course program up front will receive a discounted rate of $1,620 (10% off). Please provide billing info below. You may also call Jeniffer Fletcher, at 470-344-0256 to pay by credit card. Billing Contact Person Billing Address Billing City Billing State Billing Zip Done