2014 Employer Assurance Form Page 2
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2EMPLOYER ASSURANCE FORM INSTRUCTIONS – Revised March 2014
Note: Please complete all forms legibly in black ink or type. The name and address sections should be completed in ALL CAPS.
The Georgia PSC Employer Assurance Form should accompany all applications for certification when the applicant is employed or will be employed by a
Georgia public or private school system/agency. This form is used for the following:
To verify that the applicant is currently employed or will be employed in the listed system/agency and all required background checks have been
completed;
To exempt the applicant from the certification fee in some cases; and
To request a Permit, International Exchange, Waiver, or Non-Renewable certificate. Be sure to indicate the field code and beginning validity date
requested.
When possible, this form should be submitted electronically through the employer’s account on
CERTIFICATE FIELD CODES
TEACHING FIELDS
SERVICE FIELDS (P-12)
Foreign Languages (P-12)
Elementary Fields
Audiology – 801
American Sign Lang.
832
Birth Through Kindergarten – 870
Media Specialist – 813
Arabic
845
Early Childhood Education (P-5) – 808
School Counseling - 709
Chinese (Mandarin)
834
Early Childhood Sp Ed Gen Curriculum (P-5) – 708
School Nutrition Director – 729
Farsi
848
Middle Grades (4-8):
School Psychology– 711
French
836
Language Arts - 853
School Social Work – 715
German
838
Mathematics - 851
Speech and Language Pathology – 802
Greek (Classical)
842
Reading - 855
Curriculum & Instruction – 902
Hebrew
841
Science - 852
Instructional Technology – 903
Hindi
843
Social Science - 854
Teacher Leadership – 904
Italian
840
Secondary Fields (6-12)
Japanese
831
Agriculture– 788
LEADERSHIP FIELDS (P-12)
Korean
846
Behavioral Science – 766
Educational Leadership – 704
Latin
835
Biology – 750
Educational Leadership Building-Level – 706
Portuguese
844
Business – 783
Russian
839
Educational Leadership System-Level - 707
Chemistry – 752
Spanish
837
Earth/Space Science – 753
Swahili
847
ENDORSEMENTS
Economics – 757
Turkish
850
Teaching Endorsements:
English – 730
Urdu
849
Birth Through Five – 871
Family/Consumer Science – 790
Career Exploration (PECE) – 749
Geography – 759
Special Education (P-12) Consultative
Career Technical Instruction (CTI) – 810
Healthcare Science Technology Ed (HSTE) – 619
Sp Ed Adapted Curriculum – 805
Coaching Endorsement – 980
History – 755
Behavior Disorders – 778
Computer Science – 882
JROTC: Air Force – 643
Deaf Education – 797
Coordinated Career Academic Ed (CCAE) -770
JROTC: Army – 641
Sp Ed General Curriculum – 798
Culinary Arts – 884
JROTC: Marine Corps – 644
ECE/Sp Ed General Curriculum (P-5 only) – 708
ESOL – 825
JROTC: Navy – 642
Learning Disabilities – 777
Gifted In-Field – 881
Marketing – 792
Physical & Health Disabilities – 768
Intervention Specialist – 887
Mathematics – 743
Sp Ed Preschool (ages 3-5) – 799
K-5 Mathematics – 970
Physics – 751
Visual Impairment – 722
K-5 Science – 971
Political Science – 756
On-Line Teaching – 898
Sp Ed Academic Content Concentrations:
Science (Broad Field) – 748
Reading – 833
P-5
4-8
6-12
Speech – 733
Language Arts
930
931
932
Safety & Driver Education – 763
Technology – 769
Mathematics
910
911
912
Sp Ed Deaf Education – 874
Trade & Industrial Education:
Reading
950
951
952
Sp Ed Physical & Health Disabilities – 875
Architectural Drawing and Design – 658
Sp Ed Preschool (ages 3-5) – 826
Science
920
921
922
Audio/Video Technology & Film – 652
Sp Ed Transition Specialist – 873
Social Science
940
941
942
Automotive Service Tech – 650
Sp Ed Visual Impairment – 876
Aviation – 830
Work-Based Learning – 793
P-12 Fields
Barbering – 613
Art – 764
Collision Repair – 653
Dance – 820
Service Endorsements:
Construction - 656
Drama – 821
Student Support Team Coordinator – 888
Cosmetology – 525
Eng. To Speakers of Other Lang. (ESOL) – 885
Teacher Support and Coaching – 712
Culinary Arts - 669
Gifted (P-12) Consultative – 780
Electronics Technology – 657
Gifted Concentrations:
Esthetics – 614
Leadership Endorsements:
Language Arts – 963
Granite Technology – 659
Teacher Leader – 774
Mathematics – 961
Graphic Communications & Design – 660
Reading – 965
IT/Info Services & Support – 662
Science – 962
IT/Network Systems - 663
Social Science – 964
IT/Programming & Software Dev. – 664
Health Education - 760
IT/Interactive Media – 665
Health and Physical Education – 761
Manufacturing & Engineering Sciences – 667
Music – 767
Marine Service Technology – 618
Reading – 732
Nails – 615
Precision Machine Technology – 668
Law, Public Safety, Corrections & Security – 670
Sheet Metal – 671
Welding Technology – 673
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