Rs POST-MASTER’S EXPERIENCE UNDER DIRECTION AND SUPERVISION CONTRACT AFFIDAVIT INSTRUCTIONS: NO FAXED FORMS ACCEPTED. The purpose of this Contract Affidavit is to define the employment relationship for the purpose of acquiring the required post-master’s experience under the direction and supervision that will be applicable for licensure pursuant to O.C.G.A. § 43-10A et. seq. For the specific definitions of terms pertaining to specific licenses, see the Rules of the.
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How to fill out the GA Post-Master's Experience under Direction and Supervision Contract Affidavit online
The GA Post-Master's Experience under Direction and Supervision Contract Affidavit is essential for acquiring the required post-master’s experience for licensure in Georgia. This guide provides clear, step-by-step instructions for completing the form efficiently and accurately.
Follow the steps to complete the affidavit smoothly.
- Click the ‘Get Form’ button to access the affidavit and open it in your preferred online editor.
- Begin with Part I, where you will complete your personal information as the applicant. Fill in your full name, address, home and office telephone numbers, and social security number. Ensure all details are accurate as this information may be disclosed to relevant agencies.
- Indicate your education background by selecting the degree you have earned. If applicable, provide details of any additional coursework, including the course title and the college or university attended.
- Complete the practicum/internship section if applicable. State whether you completed a practicum/internship, along with the name of the site and the dates of this experience. Include the name of the supervisor in that program.
- Indicate the type of license you are applying for by selecting from the available options.
- Proceed to Part II, which needs to be filled out by the director of your experience site. Include their personal and professional information, including their qualifications and employment site details.
- Ensure that both the applicant and the director complete the affidavit and signature sections, attesting to the accuracy of the information and acknowledging the rules set forth.
- Move on to Part III for the supervisor's information. The supervisor must fill out their details and confirm if there is any current or prior relationship with the applicant.
- In Part IV and Part V, both the director and supervisor must outline the training experience and supervision plan, detailing the nature of services, monetary considerations, and the supervision process.
- Review the completed form thoroughly to ensure all sections are filled out completely and accurately. After verification, save changes, download, print, or share the form as necessary.
Complete your GA Post-Master's Experience under Direction and Supervision Contract Affidavit online today!
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