DATE PREFERENCE FORM



DEVELOPMENTAL ON-SITE REVIEW DATE PREFERENCE FORM

Georgia Professional Standards Commission

200 Piedmont Avenue, Suite 1702

Atlanta, Georgia 30334

Office: (404) 232-2651 Fax: (404) 232-2760

Please indicate below the dates preferred for your institution's BOE Review. Please check your institutional calendar to make sure the dates do not conflict with vacations, etc.

FALL VISITS-PREFERRED DATES BETWEEN SEPTEMBER 1 AND NOVEMBER 30

SPRING VISITS-PREFERRED DATES BETWEEN JANUARY 15 AND APRIL 30

A PSC Developmental Review typically is scheduled Sunday afternoon through Noon on Wednesday.

| |Dates |Year |

|1st Choice | | |

|2nd Choice | | |

|3rd Choice | | |

Add a list of the Preparation Program(s) to be reviewed on an attached sheet including the program title, educator preparation rule number, degrees offered and certification levels.

Institution/Agency Name:

Professional Education Unit Name:

Address:

Phone #: Fax:

Review Coordinator (Type or Print Name):

Title:

E-mail:

Telephone: Fax:

Website Address:

Review Coordinator Signature:

Unit Head Signature:

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download