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Application for online teaching endorsement certificate.

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*Today's Date

*Full Name

*食色视频 #

*PSC Login Account Number

(6 digit number that appears on your Georgia certificate and is used on correspondence to and from the PSC. If you do not have a PSC number and are therefore not a Georgia certified teacher, please type in XXXXXX in place of the 6 digit number.)

*Track to apply

Track 1 - Endorsement track for those who are certified educators in Georgia who wish to add the GaPSC approved Online Teaching Endorsement to their certifications, Track 2 - Certificate track for those educators who are in K-12 settings but not certified in Georgia or who teach in other settings and wish to gain competencies in online and blended teaching.

*Daytime Phone Number

*Email Address

*Home Address

In the Spring

I plan to take ITEC 7482--the last class in the online teaching endorsement program.I do NOT plan to take ITEC 7482--the last class in the online teaching endorsement program.

*Georgia Clear / Renewable Teaching Certificate

YesNo

I have access/ permission to teach a group of K12 students in your certification field during the spring semester for 7482

YesNo

Teaching Certification Areas/Grade Levels

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