Transcription of Georgia PSC Experience Verification Form
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Georgia PSC Experience Verification Form
Georgia PSC Experience Verification form Revised June 2021 DO NOT MAIL! Educator: Upload via MyPSC (Previous) Employer: Email as attachment to 1. Applicant Information: Title Last Name Mr. Ms. Dr. First Name Middle Name GaPSC Certification ID Number Date of Birth (MM/DD/YY) / / The Experience Verification form is used to verify educational work Experience . Please do not use this form to verify occupational work Experience for Career & Technical Specializations or Healthcare Science. This form may be used to verify: Out-of-state educator Experience : o If applying for initial Georgia certification, any out-of-state Experience earned should be verified.
The Experience Verification Form is used to verify educational work experience. Please do not use this form to verify occupational work experience for Career & Technical Specializations or Healthcare Science. This form may be used to verify: Out-of-state educator experience:
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