CharterStart Application 2016

1. CharterStart Registration

Thanks for your interest in GCSA's CharterStart training! CharterStart is a 2-day, comprehensive training program that provides founding teams with the resources, best practices, and support necessary for the development of a strong educational and operational school model that promotes the academic achievement of all students.

CharterStart participants will also receive priority consideration for the New Schools for Georgia Incubator. The Incubator is a three-year turnkey charter school development program with a dual focus on building strong, sustainable boards and developing outstanding school leaders. There is no cost for the Incubator, which includes a paid one-year, school-based internship for school leaders. Incubator participants will be primarily selected from teams that successfully complete CharterStart.

CharterStart will explore the critical components of school development planning: Academic Program; Financial Sustainability; Compliance and Operations; and Leadership. The training will also help school developers understand the petition process and timeline and develop the governance capacity to effectively lead a charter school.

CharterStart will be held on Saturday, October 18, 2016 and Saturday, October 22, 2016 from 9:00am-4:00pm. The location is TBD. The cost for the training is $350/team. Attendance on both days is required. The application deadline is Friday, September 30th and payment is due NO LATER than Wednesday, October 12th. Participation in CharterStart does not guarantee authorizer approval or participation in the Incubator. Development of the school and negotiations with local, Commission, or state agencies remains the responsibility of the petitioner.

For additional information, please contact Waynica Staples, GCSA's Director of Education & Training at

wstaples@gacharters.org or 404-835-8914.

Question Title

* 1. Please complete the information below about the primary petitioner responsible for the founding group and authorized to sign on behalf of the non-profit or initial group:

Name of Primary Petitioner: *

Address: *

Address 2:

City/Town: *

State: *

ZIP: *

Country:

Email Address: *

Phone Number: *

Question Title

* 2. Please provide the following employment information for the primary petitioner:

Company: *

Address: *

Address 2:

City/Town: *

State: *

ZIP: *

Country:

Website:

Phone Number: *

Question Title

* 3. Please select which of the following best describes you:

Start-Up Individual

Start-Up Group

Start-Up Individual working with an EMO/CMO

Start-Up Group working with an EMO/CMO

EMO Representative

Question Title

* 4. Proposed Name of School

Question Title

* 5. Please select all grade levels you are interested in serving.

1st

2nd

3rd

4th

5th

6th

7th

8th

9th

10th

11th

12th

Question Title

* 6. Please list the school district(s) you would like to serve.

District 1

District 2

District 3

District 4

District 5

Question Title

* 7. Please briefly summarize your school's focus and/or innovative or unique features.

Question Title

* 8. Please list the name, area of expertise, and email for each Founding Board Member

Member 1

Member 2

Member 3

Member 4

Member 5

Member 6

Member 7

Member 8

Member 9

Member 10

Member 11

Question Title

* 9. Will all of the founding members participate on both days of the training?

Yes

No (Please specify who will attend on the 18th and on the 22nd in the box below)

Comment (please specify)

Question Title

* 10. Please select all activities that your Founding Board has completed:

Reviewed Charter Schools Act of 1998

Reviewed State Board Rule for Charter Schools

Visited GaDOE website Charter Schools Page

Reviewed District or Commission Petition Requirements

Identified District or Commission Petition Due Date

Reviewed State Petition Requirements

Identified State Petition Due Date

Conducted Community Interest Meeting

Conducted Community Interest Survey

Visited Other Charter Schools

Attended Commission Boot Camp or GaDOE Information Session

Other (please specify)

Question Title

* 11. Please describe how you will pay for CharterStart. The cost for the training is $350 per team.

Bill me- Payment is due by October 12, 2016

Credit Card

Question Title

* 12. If charging to a credit card, please provide the credit card information below:

Type of Card

Name on the Card

Card Number

Expiration Date

CVC Number

Billing Address 1

Billing Address 2

Amount Authorized to Charge