MTSS Facilitator Endorsement Application

Candidates must meet the following criteria to apply for the MTSS Facilitator Endorsement Cohort:

Clear & renewable Georgia Teaching Certificate (T-4 or higher)
Must be employed by a Georgia school system
Letter of recommendation from District and School Administrators in the employing school system
Minimum of three years of successful teaching experience and evidence of work in the RTI/MTSS field
Must have signed "Verification of Teaching Experience Form" from Human Resources Director. (See embedded PDF. Please print, complete, scan and upload.)
Letter from immediate supervisor committing support to allow the candidate to complete all requirements in the school and/or district.

GaPSC Certification ID:*

Certification Number

Full Name*

First NameLast Name

DOB*

Date

Work E-mail*

Personal Email*

example@example.com

Work Phone #*

Cell Phone #*

Address*

Address

Address Line 2

CityState

Zip Code

System:*

School*

Gender*

FemaleMale

Ethnicity*